Organization Active NPI

The Huntington Medical Foundation

  • Internal Medicine Physician
  • Pasadena, CA
National Provider Identifier
1639225048
Registry record updated Dec 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
THE HUNTINGTON MEDICAL FOUNDATION
Practice address
65 N Madison Ave
Suite 800
Pasadena, CA 91101-2035
Phone
(626) 792-3141
Fax
(626) 792-9193
NPI assigned
Jan 26, 2007
Last updated
Dec 19, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2022

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

Authorized official

Name
Kendra Williams
Title
Director of Revenue Cycle
Phone
(626) 397-8384

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X
Internal Medicine Physician 207R00000X Primary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X

Addresses

Primary practice location

65 N Madison Ave
Suite 800
Pasadena, CA 91101-2035

Mailing address

100 W California Blvd
Pasadena, CA 91105-3010
Phone (626) 397-8335

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040923000968 CA Part B Supplier - Clinic/Group Practice 4587631601 Receives reassigned benefits from 210 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Pasadena, CA; San Marino, CA; San Diego, CA; Riverside, CA; La Canada, CA; La Canada Flintridge, CA; Los Angeles, CA; Arcadia, CA…

Other NPIs on the same Medicare enrollment 3

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0555907Huntington Medical Foundation65 N Madison St Ste 800, Pasadena, CA 91101Certificate of waiverAug 31, 2027

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671408000000",
    "number": "1639225048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 W CALIFORNIA BLVD",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053010",
            "telephone_number": "626-397-8335",
            "fax_number": "626-397-8337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 N MADISON AVE",
            "address_2": "SUITE 800",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911012035",
            "telephone_number": "626-792-3141",
            "fax_number": "626-792-9193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE HUNTINGTON MEDICAL FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "KENDRA",
        "authorized_official_title_or_position": "DIRECTOR OF REVENUE CYCLE",
        "authorized_official_telephone_number": "626-397-8384"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.