Elaine M. Madayag MD, a Professional Corporation
Organization Active NPI Internal Medicine Physician · Oakdale, CA
NPI 1629440508 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1629440508
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- A63167 (CA)
- Legal business name
- ELAINE M. MADAYAG MD, A PROFESSIONAL CORPORATION
- Practice address
- 715 W F St
Oakdale, CA 95361-3736 - Phone
- (209) 847-2920
- Fax
- (209) 847-2892
- NPI assigned
- Oct 30, 2015
- Organization subpart
- No
Authorized official
- Name
- Dr. Elaine M Madayagcapuno, MD
- Title
- Owner/Director
- Phone
- (209) 847-2920
Practitioners 1
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D2117831 | Elaine Madayag MD a Professional Corporation | Certificate of waiver | Aug 23, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20151217001616 | CA | Part B Supplier - Clinic/Group Practice | 4284935131 |
Receives reassigned benefits from 1 practitioner Practice locations: Oakdale, CA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | A63167 | CA | Yes |
| Medical Specialty Clinic/Center | 261QM2500X | A63167 | CA |
Addresses
Primary practice location
715 W F St
Oakdale, CA 95361-3736
Mailing address
PO Box 1946
Oakdale, CA 95361-1946
Phone (209) 847-2920
Other practice location 1
232 W F St
Oakdale, CA 95361-3844
Phone (209) 847-2920
Other names
- Elaine Madayag-Capuno, M.D.
Other providers in Oakdale, CA
- Pablo Felipe Duque
- Dennis G. Durr
- Jill Rebekah Dutra
- Eugene Chukwudi Echegi
- Edward Chock MD Inc
- Emilia D. Santucci, Family Therapist, a Professional Organization
- Kenneth Wayne Erickson
- Michelle Suzanne Yandell Escamilla
- Amin Esfahani
- Michelle Morales Espinosa
All providers in Oakdale, CA · Internal Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.