Individual provider Active NPI

Avery Newcomb, MD

  • Emergency Medicine Physician
  • Ukiah, CA
National Provider Identifier
1780212886
Registry record updated Aug 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A188905 Issued in CA
Practice address
242 Hospital Dr Ste B
Ukiah, CA 95482-4556
Phone
(707) 462-7900
NPI assigned
Apr 1, 2020
Last updated
Aug 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A188905 CA Primary

Addresses

Primary practice location

242 Hospital Dr Ste B
Ukiah, CA 95482-4556

Mailing address

242 Hospital Dr Ste B
Ukiah, CA 95482-4556

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
I20231226000661 CA Practitioner - Emergency Medicine 2860896859 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Alabama School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacific Redwood Medical Group IncGroup PAC ID 5496652703, 58 clinicians

Practice addresses (Care Compare)

15630 18TH Ave
Clearlake, CA 95422-9336
Phone (701) 994-6486

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
94.76
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
89.41 of 100Reported as group
Quality
86.32
Promoting interoperability
95
Improvement activities
40
Cost
66.55

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A188905CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Redwood Medical Group Inc Emergency Medicine CurrentSince Oct 10, 2023 Accepting new patients

Locations

15630 18th Ave
Clearlake, CA 95422
Phone (707) 995-5820

700 River Dr
Fort Bragg, CA 95437
Phone (707) 961-1234

10 Woodland Rd
Saint Helena, CA 94574
Phone (707) 261-7821

275 Hospital Dr
Ukiah, CA 95482
Phone (707) 462-7900

1 Marcela Dr
Willits, CA 95490
Phone (707) 456-3001

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1585699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692316800000",
    "number": "1780212886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "242 HOSPITAL DR STE B",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954824556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 HOSPITAL DR STE B",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954824556",
            "telephone_number": "707-462-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWCOMB",
        "first_name": "AVERY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-01",
        "last_updated": "2023-08-18",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A188905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ukiah, CA

Sources for this page

Verify at the official NPI Registry.