NPIMap

Organization Active NPI

Adventist Health Heart Institute-Ukiah

  • Multi-Specialty Clinic/Center
  • Ukiah, CA
National Provider Identifier
1417295643
Registry record updated Jan 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
ADVENTIST HEALTH HEART INSTITUTE-UKIAH
Practice address
115 Hospital Dr
Ukiah, CA 95482-4591
Phone
(707) 463-2400
Fax
(707) 463-3520
NPI assigned
Jan 23, 2013
Last updated
Jan 9, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2018

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

Authorized official

Name
Adrian Serna
Title
Cfo
Phone
(916) 865-1865

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

115 Hospital Dr
Ukiah, CA 95482-4591

Mailing address

PO Box 398794
San Francisco, CA 94139-8794

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050407000633 CA Part B Supplier - Clinic/Group Practice 3274580972 Receives reassigned benefits from 808 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Adventist Health Physicians166 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 282

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 282

NPI Registry JSON

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

{
    "created_epoch": "1358899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515456000000",
    "number": "1417295643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 398794",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941398794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 HOSPITAL DR",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954824591",
            "telephone_number": "707-463-2400",
            "fax_number": "707-463-3520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVENTIST HEALTH HEART INSTITUTE-UKIAH",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-23",
        "last_updated": "2018-01-09",
        "status": "A",
        "authorized_official_last_name": "SERNA",
        "authorized_official_first_name": "ADRIAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "916-865-1865"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ukiah, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2018; 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.