NPIMap

Organization Active NPI

Enloe Medical Center

Doing business as Enloe Digestive Diseases Clinic

  • Gastroenterology Physician
  • Chico, CA
National Provider Identifier
1801226162
Registry record updated May 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
230000027 Issued in CA
Legal business name
ENLOE MEDICAL CENTER
Doing business as
Enloe Digestive Diseases Clinic
Practice address
111 Raley Blvd
Suite 100
Chico, CA 95928-8351
Phone
(530) 894-8800
Fax
(530) 894-8929
NPI assigned
Nov 22, 2013
Last updated
May 28, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
ENLOE MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 28, 2014

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

Authorized official

Name
Myron E. Machula
Title
VP/Cfo
Phone
(530) 332-7357

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 230000027 CA Primary

Addresses

Primary practice location

111 Raley Blvd
Suite 100
Chico, CA 95928-8351

Mailing address

1531 Esplanade
Attn: Finance
Chico, CA 95926-3310
Phone (530) 332-7300

Other names 1

  • Enloe Digestive Diseases Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140918000591 CA Part B Supplier - Hospital Department(S) 9739092388 Receives reassigned benefits from 44 practitioners
Practice locations: Chico, CA

Other NPIs with the same Medicare PAC ID 17

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 17

National Provider Directory

National Provider Directory
Part of
Enloe General Colorectal S

Locations

111 Raley Blvd
Ste 100
Chico, CA 95928
Phone (530) 332-3986

Practitioners & affiliated clinicians

Practitioners 45

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1385078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401235200000",
    "number": "1801226162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1531 ESPLANADE",
            "address_2": "ATTN: FINANCE",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959263310",
            "telephone_number": "530-332-7300",
            "fax_number": "530-893-6853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 RALEY BLVD",
            "address_2": "SUITE 100",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959288351",
            "telephone_number": "530-894-8800",
            "fax_number": "530-894-8929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENLOE MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ENLOE MEDICAL CENTER",
        "enumeration_date": "2013-11-22",
        "last_updated": "2014-05-28",
        "status": "A",
        "authorized_official_last_name": "MACHULA",
        "authorized_official_first_name": "MYRON",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "VP/CFO",
        "authorized_official_telephone_number": "530-332-7357"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "230000027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Enloe Digestive Diseases Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chico, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.