Organization Active NPI

Foster City Medical Center

  • Urgent Care Clinic/Center
  • Foster City, CA
National Provider Identifier
1255731980
Registry record updated Aug 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
License
A125461 Issued in CA
Legal business name
FOSTER CITY MEDICAL CENTER
Practice address
1241 E Hillsdale Blvd
Suite 270
Foster City, CA 94404-1241
Phone
(650) 918-5080
NPI assigned
Aug 29, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Rajan Dave, M.D.NPI 1558703330
Title
Ceo
Phone
(650) 918-5080

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X A125461 CA
Urgent Care Clinic/Center 261QU0200X A125461 CA Primary

Addresses

Primary practice location

1241 E Hillsdale Blvd
Suite 270
Foster City, CA 94404-1241

Mailing address

1241 E Hillsdale Blvd
Suite 270
Foster City, CA 94404-1241
Phone (650) 918-5080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140930000835 CA Part B Supplier - Clinic/Group Practice 1052531878 Receives reassigned benefits from 4 practitioners
Practice locations: Foster City, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2094935Foster City Medical Center1241 E Hillsdale Blvd Suite 270, Foster City, CA 94404Certificate of waiverApr 26, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1409270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409270400000",
    "number": "1255731980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1241 E HILLSDALE BLVD",
            "address_2": "SUITE 270",
            "city": "FOSTER CITY",
            "state": "CA",
            "postal_code": "944041241",
            "telephone_number": "650-918-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1241 E HILLSDALE BLVD",
            "address_2": "SUITE 270",
            "city": "FOSTER CITY",
            "state": "CA",
            "postal_code": "944041241",
            "telephone_number": "650-918-5080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOSTER CITY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-29",
        "last_updated": "2014-08-29",
        "status": "A",
        "authorized_official_last_name": "DAVE",
        "authorized_official_first_name": "RAJAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "650-918-5080",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "A125461",
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "CA",
            "license": "A125461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Foster City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.