NPIMap

Organization Active NPI

Enloe Medical Center

Doing business as Enloe Neurosurgical & Spine Clinic

  • Neurological Surgery Physician
  • Chico, CA
National Provider Identifier
1336580422
Registry record updated May 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
23000027 Issued in CA
Legal business name
ENLOE MEDICAL CENTER
Doing business as
Enloe Neurosurgical & Spine Clinic
Practice address
251 Cohasset Rd
Suite 370
Chico, CA 95926-2241
Phone
(530) 895-3333
Fax
(530) 895-3217
NPI assigned
Jul 17, 2013
Last updated
May 28, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
ENLOE MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 28, 2014

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

Authorized official

Name
Myron Machula
Title
VP/Cfo
Phone
(530) 332-7357

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 23000027 CA Primary

Addresses

Primary practice location

251 Cohasset Rd
Suite 370
Chico, CA 95926-2241

Mailing address

1531 Esplanade
Attn: Finance
Chico, CA 95926-3310
Phone (530) 332-7300

Other names 1

  • Enloe Neurosurgical & Spine Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130731000581 CA Part B Supplier - Hospital Department(S) 9739092388 Receives reassigned benefits from 16 practitioners
Practice locations: Chico, CA; Gridley, CA

Other NPIs with the same Medicare PAC ID 17

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 17

National Provider Directory

National Provider Directory
Part of
Enloe General Colorectal S

Locations

265 Cohasset Rd
#370
Chico, CA 95926

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1374019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401235200000",
    "number": "1336580422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1531 ESPLANADE",
            "address_2": "ATTN: FINANCE",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959263310",
            "telephone_number": "530-332-7300",
            "fax_number": "530-893-6853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 COHASSET RD",
            "address_2": "SUITE 370",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959262241",
            "telephone_number": "530-895-3333",
            "fax_number": "530-895-3217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENLOE MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ENLOE MEDICAL CENTER",
        "enumeration_date": "2013-07-17",
        "last_updated": "2014-05-28",
        "status": "A",
        "authorized_official_last_name": "MACHULA",
        "authorized_official_first_name": "MYRON",
        "authorized_official_title_or_position": "VP/CFO",
        "authorized_official_telephone_number": "530-332-7357"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "23000027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Enloe Neurosurgical & Spine Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chico, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2014; 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.