NPIMap

Individual provider Active NPI

Pamela Maur, M.D.

  • Cardiovascular Disease Physician
  • Santa Rosa, CA
National Provider Identifier
1427343532
Registry record updated Sep 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
A168307 Issued in CA
Practice address
500 Doyle Park Dr Ste G04
Santa Rosa, CA 95405-4559
Phone
(707) 576-7100
NPI assigned
Jun 16, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MMD.33649 LL SC
Cardiovascular Disease Physician 207RC0000X A168307 CA Primary

Addresses

Primary practice location

500 Doyle Park Dr Ste G04
Santa Rosa, CA 95405-4559

Mailing address

169 Ashley Ave
Room 202 Main Hospital
Charleston, SC 29425-8905
Phone (843) 792-4074

Other practice location 1

169 Ashley Ave
Room 202 Main Hospital
Charleston, SC 29425-8905
Phone (843) 792-4074

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pmaur1658032@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, CA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180604002238 PA Practitioner - Internal Medicine 9234351214 Reassigns benefits to 1 organization
I20200717002726 CA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 9234351214 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
University of South Carolina School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

500 Doyle Park Dr
Suite G04
Santa Rosa, CA 95405-4559
Phone (707) 303-8360

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MMD.33649 LLSCMDInternal Medicine Physician
A168307CAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation Current Accepting new patients
St. Joseph Health Northern California, LLC CurrentSince Mar 15, 2021 Accepting new patients
St. Joseph Health Northern California, LLC CurrentSince Mar 15, 2021 Accepting new patients
Providence Medical Foundation CurrentSince Jul 13, 2020 Accepting new patients
Coatesville Cardiology Clinic LLC Cardiovascular Disease CurrentSince Apr 21, 2018 Accepting new patients
Providence Medical Foundation CurrentSince Jul 13, 2020 Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients
Providence Medical Foundation Past Accepting new patients

Locations

200 W Ctr St Promenade
Ste 300
Anaheim, CA 92805
Phone (714) 449-4841

1000 Trancas St
Napa, CA 94558
Phone (707) 226-2901

500 Doyle Park Dr
Ste 100
Santa Rosa, CA 95405
Phone (714) 449-4842

500 Doyle Park Dr
Ste G04
Santa Rosa, CA 95405
Phone (707) 303-8360

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

3025 Zinn Rd
Thorndale, PA 19372
Phone (610) 384-2211

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1308182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664236800000",
    "number": "1427343532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 ASHLEY AVE",
            "address_2": "ROOM 202 MAIN HOSPITAL",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258905",
            "telephone_number": "843-792-4074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 DOYLE PARK DR STE G04",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054559",
            "telephone_number": "707-576-7100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "169 Ashley Ave",
            "address_2": "Room 202 Main Hospital",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294258905",
            "country_code": "US",
            "telephone_number": "843-792-4074",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAUR",
        "first_name": "PAMELA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-16",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "MMD.33649 LL",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A168307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pmaur1658032@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "500 Doyle Park Dr Ste G04",
            "city": "Santa Rosa",
            "state": "CA",
            "country_code": "US",
            "postal_code": "954054559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.