Individual provider Active NPI

Nicholas Taylor, D.O.

  • Internal Medicine Physician
  • Vallejo, CA
National Provider Identifier
1689053720
Registry record updated Jul 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A16451 Issued in CA
Practice address
300 Hospital Dr
Vallejo, CA 94589
Phone
(707) 554-4444
NPI assigned
May 21, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 20A16451 CA Primary

Addresses

Primary practice location

300 Hospital Dr
Vallejo, CA 94589

Mailing address

300 Hospital Dr
Vallejo, CA 94589-2574
Phone (707) 554-4444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180725003314 CA Practitioner - Internal Medicine 1153678875 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Quantum Healthcare Medical Associates IncGroup PAC ID 5294647574, 109 clinicians

Practice addresses (Care Compare)

300 Hospital Dr
Vallejo, CA 94589-2574
Phone (707) 554-4444

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75.61 of 100Reported as individual
Quality
55.21
Improvement activities
40
Cost
67.5

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A16451CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Quantum Healthcare Medical Associates Inc. Internal Medicine CurrentSince Jul 1, 2018 Accepting new patients

Locations

400 N McDowell Blvd
Petaluma, CA 94954
Phone (707) 778-1111

300 Hospital Dr
Vallejo, CA 94589
Phone (707) 554-4107

Interoperability endpoints

  • Direct secure messaging: ntaylor410643@hisp.ehr.sutterhealth.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1432166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531267200000",
    "number": "1689053720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 HOSPITAL DR",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945892574",
            "telephone_number": "707-554-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HOSPITAL DR",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "94589",
            "telephone_number": "707-554-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "NICHOLAS",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-21",
        "last_updated": "2018-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A16451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vallejo, CA

Sources for this page

Verify at the official NPI Registry.