Active NPI
Dignity Health Medical Foundation
- Multi-Specialty Clinic/Center
- Sacramento, CA
National Provider Identifier
1861795320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Multi-Specialty Clinic/Center
- Legal business name
- DIGNITY HEALTH MEDICAL FOUNDATION
- Practice address
- 3941 J St
Suite 270
Sacramento, CA 95819-3624 - Phone
- (916) 733-6850
- Fax
- (916) 733-6824
- NPI assigned
- Dec 6, 2010
- Organization subpart
- Yes
- Parent organization
- DIGNITY HEALTH MEDICAL FOUNDATION
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Theresa M Hylen
- Title
- Chief Financial Officer
- Phone
- (916) 851-2559
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Multi-Specialty Clinic/Center | 261QM1300X | Primary |
Addresses
Primary practice location
3941 J St
Suite 270
Sacramento, CA 95819-3624
Mailing address
3000 Q St
Sacramento, CA 95816-7058
Phone (916) 733-5701
Other names 1
- Mercy Medical Group, a service of Dignity Health Medical Foundation
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031107000709 | CA | Part B Supplier - Clinic/Group Practice | 7810800661 |
Receives reassigned benefits from 1,333 practitioners This NPI is an additional NPI on the enrollment |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D0928862 | Dignity Health Medical Foundation | Certificate of waiver | May 28, 2027 |
National Provider Directory
National Provider Directory- Part of
- Woodland Clinic Med GRP
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1291593600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1605657600000",
"number": "1861795320",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3000 Q ST",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958167058",
"telephone_number": "916-733-5701",
"fax_number": "916-859-1671"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3941 J ST",
"address_2": "SUITE 270",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958193624",
"telephone_number": "916-733-6850",
"fax_number": "916-733-6824"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DIGNITY HEALTH MEDICAL FOUNDATION",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "DIGNITY HEALTH MEDICAL FOUNDATION",
"enumeration_date": "2010-12-06",
"last_updated": "2020-11-18",
"certification_date": "2020-11-18",
"status": "A",
"authorized_official_last_name": "HYLEN",
"authorized_official_first_name": "THERESA",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
"authorized_official_telephone_number": "916-851-2559"
},
"taxonomies": [
{
"code": "261QM1300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Multi-Specialty",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Mercy Medical Group, a service of Dignity Health Medical Foundation",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Mercy Medical Group, a service of Dignity Health Medical Foundation",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.