NPIMap

Organization Active NPI

Enloe Medical Center

Doing business as Enloe Trauma & Surgery Clinic

  • Surgery Physician
  • Chico, CA
National Provider Identifier
1477975613
Registry record updated Aug 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
230000027 Issued in CA
Legal business name
ENLOE MEDICAL CENTER
Doing business as
Enloe Trauma & Surgery Clinic
Practice address
1600 Esplanade
Suite C
Chico, CA 95926-3369
Phone
(530) 332-7300
Fax
(530) 893-6885
NPI assigned
Jan 7, 2014
Last updated
Aug 24, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
ENLOE MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 24, 2022

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

Authorized official

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X NU
Mammography Clinic/Center 261QR0206X NU
Surgery Physician 208600000X 230000027 CA Primary

Addresses

Primary practice location

1600 Esplanade
Suite C
Chico, CA 95926-3369

Mailing address

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

Other names 1

  • Enloe Trauma & Surgery Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, CO, KS, WI, MN, VA, ID, WA, CT, OH, TX, DC, GA, SC, NC, FL, OR, UT, MA, MI, NJ, AR, NV, MD26 enrollments

Enrollment records 26

Enrollment IDStateProvider typePAC IDDetails
O20031110000404 CA Part B Supplier - Clinic/Group Practice 9739092388 Receives reassigned benefits from 242 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Chico, CA
O20140401001696 CA Part B Supplier - Hospital Department(S) 9739092388 Receives reassigned benefits from 204 practitioners
Practice locations: Chico, CA; Chino Hills, CA; San Diego, CA
O20180919003157 CO Part B Supplier - Clinic/Group Practice 9739092388 Practice locations: Steamboat Springs, CO; Parker, CO; Longmont, CO; Grand Junction, CO; Denver, CO; Colorado Springs, CO; Centennial, CO
O20180920002018 KS Part B Supplier - Clinic/Group Practice 9739092388 Receives reassigned benefits from 3 practitioners
Practice locations: Wichita, KS; Hays, KS; Topeka, KS
O20180921000211 WI Part B Supplier - Clinic/Group Practice 9739092388 Receives reassigned benefits from 1 practitioner
Practice locations: Beloit, WI; Brookfield, WI
O20180921001875 MN Part B Supplier - Clinic/Group Practice 9739092388 Receives reassigned benefits from 1 practitioner
Practice locations: Edina, MN; Plymouth, MN; Maple Grove, MN; Fergus Falls, MN
O20180924003655 VA Part B Supplier - Clinic/Group Practice 9739092388 Receives reassigned benefits from 9 practitioners
Practice locations: Alexandria, VA; Williamsburg, VA; Portsmouth, VA; Middleburg, VA; Leesburg, VA; Hillsboro, VA; Glen Allen, VA; Earlysville, VA
O20180925003373 ID Part B Supplier - Clinic/Group Practice 9739092388 Receives reassigned benefits from 2 practitioners
Practice locations: Coeur D Alene, ID
O20180925003908 WA Part B Supplier - Clinic/Group Practice 9739092388 Receives reassigned benefits from 4 practitioners
Practice locations: Bellevue, WA; Woodinville, WA; Seattle, WA; Liberty Lake, WA
O20180926000159 CT Part B Supplier - Clinic/Group Practice 9739092388 Receives reassigned benefits from 2 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hartford, CT
O20180926003543 OH Part B Supplier - Clinic/Group Practice 9739092388 Receives reassigned benefits from 3 practitioners
Practice locations: Aurora, OH; New Albany, OH; Westlake, OH
O20181008000285 TX Part B Supplier - Clinic/Group Practice 9739092388 Receives reassigned benefits from 5 practitioners
Practice locations: Austin, TX; Spicewood, TX; Houston, TX; Corpus Christi, TX
O20181024001108 DC Part B Supplier - Clinic/Group Practice 9739092388 Receives reassigned benefits from 4 practitioners
Practice locations: Alexandria, VA; Great Falls, VA; MC Lean, VA
O20181217000780 GA Part B Supplier - Clinic/Group Practice 9739092388 Receives reassigned benefits from 3 practitioners
Practice locations: Augusta, GA; Clayton, GA; Macon, GA
O20190322001410 SC Part B Supplier - Clinic/Group Practice 9739092388 Receives reassigned benefits from 1 practitioner
Practice locations: Sullivans Island, SC
O20200218000779 NC Part B Supplier - Clinic/Group Practice 9739092388 Receives reassigned benefits from 2 practitioners
Practice locations: Cary, NC; Greensboro, NC
O20200612001471 FL Part B Supplier - Clinic/Group Practice 9739092388 Receives reassigned benefits from 8 practitioners
Practice locations: Palm City, FL; Wellington, FL; Sarasota, FL; Miami Beach, FL; Melbourne Beach, FL; Fleming Island, FL
O20200922002732 OR Part B Supplier - Clinic/Group Practice 9739092388 Receives reassigned benefits from 3 practitioners
Practice locations: La Grande, OR; Salem, OR; Portland, OR
O20200923002438 UT Part B Supplier - Clinic/Group Practice 9739092388 Receives reassigned benefits from 2 practitioners
Practice locations: St George, UT; Sandy, UT
O20210325001510 MA Part B Supplier - Clinic/Group Practice 9739092388 Receives reassigned benefits from 2 practitioners
Practice locations: Lexington, MA; Weymouth, MA
O20210405001978 MI Part B Supplier - Clinic/Group Practice 9739092388 Receives reassigned benefits from 5 practitioners
Practice locations: Ann Arbor, MI; Grand Blanc, MI; West Bloomfield, MI
O20211001000196 NJ Part B Supplier - Clinic/Group Practice 9739092388 Receives reassigned benefits from 1 practitioner
Practice locations: Princeton, NJ; Tinton Falls, NJ
O20220629002579 VA Part B Supplier - Clinic/Group Practice 9739092388 Receives reassigned benefits from 1 practitioner
Practice locations: Richmond, VA
O20230207001522 AR Part B Supplier - Clinic/Group Practice 9739092388 Receives reassigned benefits from 1 practitioner
Practice locations: Little Rock, AR
O20240229000285 NV Part B Supplier - Clinic/Group Practice 9739092388 Receives reassigned benefits from 1 practitioner
Practice locations: Reno, NV
O20250122000715 MD Part B Supplier - Clinic/Group Practice 9739092388 Receives reassigned benefits from 1 practitioner
Practice locations: Clarksville, MD

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

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Enloe General Colorectal S

Locations

975 E Nerge Rd
Ste 90
Roselle, IL 60172

Practitioners & affiliated clinicians

Practitioners 323

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 323

NPI Registry JSON

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

{
    "created_epoch": "1389052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661299200000",
    "number": "1477975613",
    "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": "1600 ESPLANADE",
            "address_2": "SUITE C",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959263369",
            "telephone_number": "530-332-7300",
            "fax_number": "530-893-6885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENLOE MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ENLOE MEDICAL CENTER",
        "enumeration_date": "2014-01-07",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A",
        "authorized_official_last_name": "MACHULA",
        "authorized_official_first_name": "MYRON",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "VP/CFO",
        "authorized_official_telephone_number": "530-332-7357"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0206X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mammography",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "230000027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Enloe Trauma & Surgery Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Enloe Trauma & Surgery 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 Aug 24, 2022; 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.