Dignity Health Medical Foundation
Organization Active NPI Multi-Specialty Clinic/Center · Santa Cruz, CA
NPI 1649446352 · NPPES record last updated Nov 18, 2020
Key facts
- NPI
- 1649446352
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Multi-Specialty Clinic/Center 261QM1300X
- Legal business name
- DIGNITY HEALTH MEDICAL FOUNDATION
- Practice address
- 2018 Mission St
Santa Cruz, CA 95060-5218 - Phone
- (831) 465-7761
- NPI assigned
- May 2, 2008
- Organization subpart
- Yes
- Parent organization (as reported)
- DIGNITY HEALTH MEDICAL FOUNDATION
Authorized official
- Name
- Theresa M Hylen
- Title
- Chief Financial Officer
- Phone
- (916) 851-2559
Practitioners 97
-
Marian Elliot Acquistapace, CNM/FNP
-
David Anjelly, M.D.
-
Nicole A Baisden, NP
-
Sneha Sri Bathina, CNM
-
John D Bergren, MD
-
Talia Mariam Brinton, PA-C
-
Hsuan-Chih Chen, MD
-
Robert P. Chen, M.D.
-
Patrick A Cudahy, MD
-
Gael F Decleve, D.O.
-
Brenda D Deering, PA
-
Cindy Dillard, NP
-
Erin Cathleen Duffy, PA-C
-
Miesha Farahmand, MD
-
Leora Fromm, RN, CNM
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D1086135 | Dignity Health Medical Foundation | Provider-performed microscopy | Jul 2, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031107000709 | CA | Part B Supplier - Clinic/Group Practice | 7810800661 |
Receives reassigned benefits from 1,333 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
- Part of
- Woodland Clinic Med GRP
Locations
9515 Soquel Dr
Aptos, CA 95003
Phone (831) 612-6283
1820 41st Ave
Capitola, CA 95010
Phone (831) 476-3000
1824 41St Ave C
Capitola, CA 95010
6215 Highway 9
Felton, CA 95018
Phone (831) 335-9111
1595 Soquel Dr
Ste 400
Los Angeles, CA 90074
585 Buckingham Way
San Francisco, CA 94132
Phone (415) 379-2000
1595 Soquel Dr
Ste 310
Santa Cruz, CA 95065
Phone (831) 464-8880
1595 Soquel Dr
Ste 1
Santa Cruz, CA 95065
1667 Dominican Way
Ste 234
Santa Cruz, CA 95065
Phone (831) 476-3363
1505 Soquel Dr
Ste 1
Santa Cruz, CA 95065
Phone (831) 462-3800
1667 Dominican Way
Ste 134
Santa Cruz, CA 95065
Phone (831) 475-8834
700 Frederick St
Santa Cruz, CA 95062
Phone (831) 288-5234
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Multi-Specialty Clinic/Center | 261QM1300X | Yes |
Addresses
Primary practice location
2018 Mission St
Santa Cruz, CA 95060-5218
Mailing address
3000 Q St
Sacramento, CA 95816-7058
Phone (916) 733-5701
Other names
- Dignity Health Medical Group - Dominican, a service of Dignity Health
Other providers in Santa Cruz, CA
- Nancy E Diehl
- Dientes Community Dental Care.
- Dignity Health
- Dignity Health
- Dignity Health Medical Foundation
- Cindy Dillard
- Courtney Jane Dimpel
- Caitlin Nicole Dios
- Casey Diraimondo
- Tina Hope Distad
All providers in Santa Cruz, CA · Multi-Specialty Clinic/Center in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 18, 2020. 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.