Organization Active NPI

Healthtap Medical Group, PC

  • General Practice Physician
  • Portola Valley, CA
National Provider Identifier
1376136499
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
HEALTHTAP MEDICAL GROUP, PC
Practice address
4370 Alpine Road
Ste 206
Portola Valley, CA 94028-7953
Phone
(650) 268-9806
NPI assigned
Feb 19, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Authorized official

Name
Mr. Michael Nichols, JD
Title
Assistant Secretary
Phone
(650) 268-9806

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

4370 Alpine Road
Ste 206
Portola Valley, CA 94028-7953

Mailing address

209 E Java Dr
Unit 61987
Sunnyvale, CA 94088-8020
Phone (650) 268-9806

National Provider Directory

National Provider Directory

Locations

4370 Alpine Rd
Ste 206
Portola Valley, CA 94028
Phone (650) 268-9806

NPI Registry JSON

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

{
    "created_epoch": "1613692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726444800000",
    "number": "1376136499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 E JAVA DR",
            "address_2": "UNIT 61987",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940888020",
            "telephone_number": "650-268-9806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4370 ALPINE ROAD",
            "address_2": "STE 206",
            "city": "PORTOLA VALLEY",
            "state": "CA",
            "postal_code": "940287953",
            "telephone_number": "650-268-9806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHTAP MEDICAL GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-19",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A",
        "authorized_official_last_name": "NICHOLS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "650-268-9806",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "JD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portola Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.