Organization Active NPI

North East Medical Services

  • Federally Qualified Health Center (FQHC)
  • San Francisco, CA
National Provider Identifier
1275017691
Registry record updated Sep 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
NORTH EAST MEDICAL SERVICES
Doing business as
North East Medical Services - 1422 Noriega
Practice address
1422 Noriega St
San Francisco, CA 94122-4432
Phone
(415) 391-9686
NPI assigned
Sep 21, 2018
Organization subpart
Yes
Parent organization
NORTH EAST MEDICAL SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 21, 2018

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

Authorized official

Name
Eddie W Chan
Title
President & Ceo
Phone
(415) 391-9686

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

1422 Noriega St
San Francisco, CA 94122-4432

Mailing address

1520 Stockton St
San Francisco, CA 94133-3354
Phone (415) 391-9686

Other names 1

  • North East Medical Services - 1422 Noriega Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040224001157 CA Part B Supplier - Clinic/Group Practice 4284520529 Receives reassigned benefits from 183 practitioners
19 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: San Francisco, CA; South San Francisco, CA; San Jose, CA; Daly City, CA

Other NPIs on the same Medicare enrollment 19

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 19

National Provider Directory

National Provider Directory
Tax ID family
North East Medical Services57 organizations share this tax ID, including this one
Part of
North East Medical Services

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 9

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": "1537488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537488000000",
    "number": "1275017691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 STOCKTON ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941333354",
            "telephone_number": "415-391-9686",
            "fax_number": "415-433-4726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1422 NORIEGA ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941224432",
            "telephone_number": "415-391-9686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH EAST MEDICAL SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTH EAST MEDICAL SERVICES",
        "enumeration_date": "2018-09-21",
        "last_updated": "2018-09-21",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "EDDIE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "415-391-9686"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North East Medical Services - 1422 Noriega",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.