Organization Active NPI

Obstetrics and Gynecology Medical Associates of Redding, Inc.

  • Obstetrics & Gynecology Physician
  • Redding, CA
National Provider Identifier
1619053899
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
OBSTETRICS AND GYNECOLOGY MEDICAL ASSOCIATES OF REDDING, INC.
Practice address
2650 Edith Ave
Redding, CA 96001-3043
Phone
(530) 244-2130
Fax
(530) 244-8071
NPI assigned
Oct 31, 2006
Last updated
Aug 16, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2023

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

Authorized official

Name
Ashley L Pogodzinski
Title
Manager
Phone
(530) 244-2130

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X Primary

Addresses

Primary practice location

2650 Edith Ave
Redding, CA 96001-3043

Mailing address

2626 Edith Avenue
Suite B
Redding, CA 96001
Phone (530) 244-2130

Other identifiers 3

IdentifierTypeStateIssuer
00A325060MedicaidCA
00A432370MedicaidCA
00G399660MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040406000645 CA Part B Supplier - Clinic/Group Practice 0648263657 Receives reassigned benefits from 3 practitioners
Practice locations: Redding, CA

National Provider Directory

National Provider Directory

Locations

2135 Airpark Dr
Redding, CA 96001
Phone (530) 241-5270

2626 Edith Ave
Ste B
Redding, CA 96001
Phone (530) 244-2130

2650 Edith Ave
Redding, CA 96001
Phone (530) 242-2177

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692144000000",
    "number": "1619053899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2626 EDITH AVENUE",
            "address_2": "SUITE B",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "96001",
            "telephone_number": "530-244-2130",
            "fax_number": "530-244-8071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 EDITH AVE",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960013043",
            "telephone_number": "530-244-2130",
            "fax_number": "530-244-8071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OBSTETRICS AND GYNECOLOGY MEDICAL ASSOCIATES OF REDDING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-31",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A",
        "authorized_official_last_name": "POGODZINSKI",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "530-244-2130"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A325060",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A432370",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G399660",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; 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.