NPIMap

Organization Active NPI

Sierra Nevada Gastroenterology Medical Associates, Inc.

  • Specialist
  • Grass Valley, CA
National Provider Identifier
1407928641
Registry record updated Apr 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
SIERRA NEVADA GASTROENTEROLOGY MEDICAL ASSOCIATES, INC.
Practice address
300 Sierra College Dr
Ste.105
Grass Valley, CA 95945-5082
Phone
(530) 273-3377
Fax
(530) 273-3387
NPI assigned
Nov 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2008

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

Authorized official

Name
Andrew Chang, M.D.NPI 1396702874
Title
President
Phone
(530) 273-3377

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
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

300 Sierra College Dr
Ste.105
Grass Valley, CA 95945-5082

Mailing address

300 Sierra College Dr
Ste.105
Grass Valley, CA 95945-5082
Phone (530) 273-3377

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050708000842 CA Part B Supplier - Clinic/Group Practice 8325074669 Receives reassigned benefits from 7 practitioners
Practice locations: Grass Valley, CA

National Provider Directory

National Provider Directory

Locations

300 Sierra College Dr
Ste 220
Grass Valley, CA 95945
Phone (530) 273-0055

Practitioners & affiliated clinicians

Practitioners 7

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": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208908800000",
    "number": "1407928641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SIERRA COLLEGE DR",
            "address_2": "STE.105",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959455082",
            "telephone_number": "530-273-3377",
            "fax_number": "530-273-3387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 SIERRA COLLEGE DR",
            "address_2": "STE.105",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959455082",
            "telephone_number": "530-273-3377",
            "fax_number": "530-273-3387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIERRA NEVADA GASTROENTEROLOGY MEDICAL ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2008-04-23",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "530-273-3377",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grass Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2008; 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.