Organization Active NPI

Merced Womens Center for Advanced Pelvic Surgery

  • Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
  • Merced, CA
National Provider Identifier
1326525650
Registry record updated Jul 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianTaxonomy code 207VF0040X
Legal business name
MERCED WOMENS CENTER FOR ADVANCED PELVIC SURGERY
Practice address
900 W Olive Ave Ste a
Merced, CA 95348
Phone
(209) 579-5628
NPI assigned
Jul 19, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2018

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

Authorized official

Name
Diane Thomas, MDNPI 1376882357
Title
Owner
Phone
(415) 286-1616

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VF0040X Primary

Addresses

Primary practice location

900 W Olive Ave Ste a
Merced, CA 95348

Mailing address

220 Standiford Ave Ste F
Modesto, CA 95350-1159
Phone (209) 579-5628

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190311002146 CA Part B Supplier - Clinic/Group Practice 9436498367 Receives reassigned benefits from 1 practitioner
Practice locations: Turlock, CA; Merced, 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
05D2155306Merced Womens Center900 W Olive Avenue, Merced, CA 95348Certificate of waiverSep 25, 2026

National Provider Directory

National Provider Directory

Locations

900 W Olive Ave
Ste A
Merced, CA 95348
Phone (209) 388-0730

Practitioners & affiliated clinicians

Practitioners 1

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": "1531958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532304000000",
    "number": "1326525650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 STANDIFORD AVE STE F",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953501159",
            "telephone_number": "209-579-5628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 W OLIVE AVE STE A",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "95348",
            "telephone_number": "209-579-5628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCED WOMENS CENTER FOR ADVANCED PELVIC SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-19",
        "last_updated": "2018-07-23",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "415-286-1616",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VF0040X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merced, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2018; 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.