NPIMap

Organization Active NPI

Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
National Provider Identifier
1497971584
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
CLF 11121 Issued in CA
Legal business name
PERMANENTE MEDICAL GROUP, INC
Practice address
5755 Cottle Rd BLDG 6
TPMG Regional Genetics Lab
San Jose, CA 95123-3640
Phone
(408) 972-3308
NPI assigned
Apr 17, 2007
Last updated
Nov 20, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
PERMANENTE MEDICAL GROUP, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Authorized official

Name
Ms. Patricia T West
Title
VP Finance
Phone
(510) 295-7207

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X CLF 11121 CA Primary

Addresses

Primary practice location

5755 Cottle Rd BLDG 6
TPMG Regional Genetics Lab
San Jose, CA 95123-3640

Mailing address

5820 Owens Dr. Building E, 2ND Floor
TPMG Financial Management
Pleasanton, CA 94588-3900

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091105000425 CA Part B Supplier - Independent Clinical Laboratory 8921910225 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Berkeley, CA; Richmond, CA; San Jose, CA

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Tax ID family
The Perm Med GRP Inc26 organizations share this tax ID, including this one
Part of
The Perm Med GRP Inc

Other organizations with this tax ID 24

Organizations that report the same tax identification number in the National Provider Directory.

View all 24

Locations (25 of 113)

2401 Blanding Ave
Alameda, CA 94501
Phone (510) 486-1467

2621 10th St
Berkeley, CA 94710
Phone (510) 418-4079

2655 Shattuck Ave
Berkeley, CA 94704
Phone (510) 486-8706

4510 Ohara Ave
Ste B
Brentwood, CA 94513
Phone (925) 513-7135

1331 Camden Ave
Campbell, CA 95008
Phone (408) 377-4030

220 E Hacienda Ave
Bldg D
Campbell, CA 95008
Phone (408) 871-6500

3847 Walnut Ave
Carmichael, CA 95608
Phone (916) 974-2060

6406 Tupelo Dr
Ste A
Citrus Heights, CA 95621
Phone (916) 721-1800

2071 Herndon Ave
Clovis, CA 93611
Phone (559) 324-5000

395 Hickey Blvd
Daly City, CA 94015
Phone (650) 301-4652

4660 Central Way
Fairfield, CA 94534
Phone (707) 425-0315

490 Chadbourne Rd
Ste D
Fairfield, CA 94534
Phone (707) 434-9088

1261 E Hillsdale Blvd
Foster City, CA 94404
Phone (415) 570-2299

43971 Boscell Rd
Fremont, CA 94538
Phone (510) 354-3225

2666 N Grove Industrial Dr
Fresno, CA 93727
Phone (661) 854-3699

560 E Herndon Ave
Ste 101
Fresno, CA 93720
Phone (559) 432-5278

6737 N Willow Ave
Ste C
Fresno, CA 93710
Phone (559) 324-1070

7800 Arroyo Cir
Ste 100
Gilroy, CA 95020
Phone (408) 842-9258

565 Sir Francis Drake Blvd
Greenbrae, CA 94904
Phone (415) 924-8622

402 W 8th St
Hanford, CA 93230
Phone (209) 634-0014

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

21615 Hesperian Blvd
Hayward, CA 94541

26660 Patrick Ave
Hayward, CA 94544
Phone (510) 782-1845

27350 Tampa Ave
Hayward, CA 94544
Phone (510) 738-8150

811 Sterling Pkwy
Lincoln, CA 95648
Phone (916) 434-5597

Practitioners & affiliated clinicians

Practitioners 19,827

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 19,827

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732060800000",
    "number": "1497971584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5820 OWENS DR. BUILDING E, 2ND FLOOR",
            "address_2": "TPMG FINANCIAL MANAGEMENT",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945883900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5755 COTTLE RD BLDG 6",
            "address_2": "TPMG REGIONAL GENETICS LAB",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951233640",
            "telephone_number": "408-972-3308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERMANENTE MEDICAL GROUP, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PERMANENTE MEDICAL GROUP, INC.",
        "enumeration_date": "2007-04-17",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A",
        "authorized_official_last_name": "WEST",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "510-295-7207",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "CLF 11121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "5755 Cottle Rd Bldg 6",
            "city": "San Jose",
            "state": "CA",
            "country_code": "US",
            "postal_code": "951233640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; 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.