NPIMap

Organization Active NPI

Sutter Bay Medical Foundation

  • Ambulatory Surgical Clinic/Center
  • Fremont, CA
National Provider Identifier
1306241534
Registry record updated Mar 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
SUTTER BAY MEDICAL FOUNDATION
Practice address
3120 Kearney St
Fremont, CA 94538-2292
Phone
(650) 498-3600
NPI assigned
Oct 30, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2026

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

Authorized official

Name
Kristin Keller
Title
Sr. Director, Planning and Alignmen
Phone
(650) 934-7000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

3120 Kearney St
Fremont, CA 94538-2292

Mailing address

325 Distel Cir
Los Altos, CA 94022-1408

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090506000097 CA Part B Supplier - Ambulatory Surgical Center 4284538778 Receives reassigned benefits from 397 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fremont, CA

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Sutter Health Palo Alto Medical FoundationCCN 05C0002080
Medicare certification status
ActiveFrom the Provider of Services file

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
05D2095231Sutter Bay Medical Foundation3120 Kearney St, Fremont, CA 94538Certificate of waiverMay 3, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 380

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

View all 380

NPI Registry JSON

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

{
    "created_epoch": "1414627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773792000000",
    "number": "1306241534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3120 KEARNEY ST",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945382292",
            "telephone_number": "650-498-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUTTER BAY MEDICAL FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-30",
        "last_updated": "2026-03-18",
        "certification_date": "2026-03-18",
        "status": "A",
        "authorized_official_last_name": "KELLER",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_title_or_position": "SR. DIRECTOR, PLANNING AND ALIGNMEN",
        "authorized_official_telephone_number": "650-934-7000"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2026; 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.