Individual provider Active NPI

Kevin Coldwater

  • Family Medicine Physician
  • Watsonville, CA
National Provider Identifier
1740345271
Registry record updated Nov 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A11364 Issued in CA
Practice address
45 Nielson St
Watsonville, CA 95076-2468
Phone
(831) 728-0222
NPI assigned
Dec 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A11364 CA Primary

Addresses

Primary practice location

45 Nielson St
Watsonville, CA 95076-2468

Mailing address

3220 Gross Rd
Santa Cruz, CA 95062-2057
Phone (831) 406-7656

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
I20141215001814 CA Practitioner - Family Practice 1456584648 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Midwestern University, Chicago College of Osteopathic Med, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Salud Para la GenteGroup PAC ID 8729984729, 41 clinicians

Practice addresses (Care Compare)

204 E Beach St
Watsonville, CA 95076-4809
Phone (831) 728-8250

Hospital & facility affiliations

  • Bridge Home Health Home health agency, Salinas, CA, CCN 559775
  • Choice Home Health Care Home health agency, Monterey, CA, CCN 557461
  • Watsonville Community Hospital Hospital, Watsonville, CA, CCN 050194

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11364CAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Salud Para la Gente CurrentSince Oct 22, 2014 Accepting new patients
Salud Para la Gente CurrentSince Oct 22, 2014 Accepting new patients
Salud Para la Gente Current Accepting new patients
Watsonville Hospital Corporation Past Accepting new patients
Salud Para la Gente Past Accepting new patients

Locations

195 Aviation Way
Ste 200
Watsonville, CA 95076

204 E Beach St
Watsonville, CA 95076
Phone (831) 763-3413

45 Nielson St
Watsonville, CA 95076
Phone (831) 761-1588

Organizations & group practices 5

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 3

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": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321401600000",
    "number": "1740345271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3220 GROSS RD",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950622057",
            "telephone_number": "831-406-7656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 NIELSON ST",
            "city": "WATSONVILLE",
            "state": "CA",
            "postal_code": "950762468",
            "telephone_number": "831-728-0222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLDWATER",
        "first_name": "KEVIN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-26",
        "last_updated": "2011-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A11364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watsonville, CA

Sources for this page

Verify at the official NPI Registry.