Individual provider Active NPI

William Cooper Eidenmuller IV, M.D.

  • Emergency Medicine Physician
  • Modesto, CA
National Provider Identifier
1831388339
Registry record updated Jan 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A98306 Issued in CA
Practice address
1700 Coffee Rd
Modesto, CA 95355-2803
Phone
(209) 569-7600
NPI assigned
Oct 19, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2010

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 A98306 CA Primary

Addresses

Primary practice location

1700 Coffee Rd
Modesto, CA 95355-2803

Mailing address

1700 Coffee Rd
Modesto, CA 95355-2803

Other identifiers 1

IdentifierTypeStateIssuer
1831388339MedicaidCA

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
I20080213000318 CA Practitioner - Emergency Medicine 6002999117 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A98306CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California Emergency Medicine CurrentSince Apr 1, 2011 Accepting new patients
Cep America-California Emergency Medicine CurrentSince Apr 1, 2011 Accepting new patients
Team Physicians of California Medical Group Inc Emergency Medicine CurrentSince Jul 1, 2014 Accepting new patients
Chase Dennis Emergency Medical Group Inc Emergency Medicine CurrentSince Oct 1, 2013 Accepting new patients
Cep America - California Emergency Medicine Current Accepting new patients

Locations

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

2700 Dolbeer St
Eureka, CA 95501
Phone (707) 269-4229

1650 Creekside Dr
Folsom, CA 95630
Phone (916) 983-7400

3300 Renner Dr
Fortuna, CA 95540
Phone (707) 725-3361

975 S Fairmont Ave
Lodi, CA 95240
Phone (209) 339-7575

520 W I St
Los Banos, CA 93635
Phone (209) 724-0316

1700 Coffee Rd
Modesto, CA 95355
Phone (209) 526-4500

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

170 Alameda de las Pulgas
Redwood City, CA 94062
Phone (650) 367-5536

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

2801 L St
Sacramento, CA 95816
Phone (916) 454-2222

1165 Montgomery Dr
Santa Rosa, CA 95405
Phone (707) 525-5300

Interoperability endpoints

  • Direct secure messaging: weidenmuller26695@hisp.ehr.sutterhealth.org

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

NPI Registry JSON

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

{
    "created_epoch": "1192752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264118400000",
    "number": "1831388339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 COFFEE RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953552803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 COFFEE RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953552803",
            "telephone_number": "209-569-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EIDENMULLER",
        "first_name": "WILLIAM",
        "middle_name": "COOPER",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-19",
        "last_updated": "2010-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A98306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1831388339",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.