County of San Mateo
Organization Active NPI Multi-Specialty Clinic/Center · San Mateo, CA
NPI 1710065792 · NPPES record last updated Oct 23, 2025
Key facts
- NPI
- 1710065792
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Multi-Specialty Clinic/Center 261QM1300X
- Legal business name
- COUNTY OF SAN MATEO
- Practice address
- 222 W 39TH Ave
San Mateo, CA 94403-4364 - Phone
- (650) 573-3962
- NPI assigned
- Nov 1, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- COUNTY OF SAN MATEO
Authorized official
- Name
- Jennifer Papa
- Title
- Chief Financial Officer
- Phone
- (650) 573-2613
Other NPIs on the same Medicare enrollment 36
Corporate family (same tax ID) 24
Practitioners 1
-
Chris B Threatt, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031126000292 | CA | Part B Supplier - Clinic/Group Practice | 9032023171 |
Receives reassigned benefits from 605 practitioners 36 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Redwood City, CA; San Mateo, CA; San Bruno, CA; South San Francisco, CA; Woodside, CA; Daly City, CA; Belmont, CA; Colma, CA… |
National Provider Directory
- Tax ID family
- Harold D Chope Comm Pat
- Part of
- Harold D Chope Comm Pat
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Multi-Specialty Clinic/Center | 261QM1300X | Yes |
Addresses
Primary practice location
222 W 39TH Ave
San Mateo, CA 94403-4364
Mailing address
222 W 39TH Ave
San Mateo, CA 94403-4364
Phone (650) 573-3962
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZZ93226Z | Other | CA | BLUE SHIELD |
| GR0028860 | Medicaid | CA |
Other names
- San Mateo Medicl Center
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Ability Network |
NPI Registry JSON
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1761177600000",
"number": "1710065792",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "222 W 39TH AVE",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944034364",
"telephone_number": "650-573-3962"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "222 W 39TH AVE",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944034364",
"telephone_number": "650-573-3962"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COUNTY OF SAN MATEO",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "COUNTY OF SAN MATEO",
"enumeration_date": "2006-11-01",
"last_updated": "2025-10-23",
"certification_date": "2025-10-23",
"status": "A",
"authorized_official_last_name": "PAPA",
"authorized_official_first_name": "JENNIFER",
"authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
"authorized_official_telephone_number": "650-573-2613"
},
"taxonomies": [
{
"code": "261QM1300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Multi-Specialty",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "ZZZ93226Z",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0028860",
"state": "CA"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
"affiliation": "Y",
"endpointDescription": "2.16.840.1.113883.3.667.2",
"affiliationName": "Ability Network",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "64 S Price Rd Ste B",
"city": "Brownsville",
"state": "TX",
"country_code": "US",
"postal_code": "785212459",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"organization_name": "San Mateo Medicl Center",
"code": "3",
"type": "Doing Business As"
}
]
}
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 23, 2025. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.