NPIMap

Individual provider Active NPI

Gregory S Holst, MD

  • Family Medicine Physician
  • Eureka, CA
National Provider Identifier
1881601615
Registry record updated Feb 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C52586 Issued in CA
Practice address
2675 Harris Street
Eureka, CA 95503
Phone
(707) 443-8335
Fax
(707) 443-7327
NPI assigned
Aug 2, 2006
Last updated
Feb 15, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2021

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 C52586 CA Primary

Addresses

Primary practice location

2675 Harris Street
Eureka, CA 95503

Mailing address

2675 Harris Street
Eureka, CA 95503
Phone (707) 443-8335

Other identifiers 6

IdentifierTypeStateIssuer
84601413802OtherCOPACIFICARE PROV #
846014138009OtherCOROCKY MTN HMO PROV #
H0615462OtherCOBCBS PROV #
84601413812MedicaidNE
01355239MedicaidCO
080182153OtherCORR MCR PROV #

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gregoryholst@sjhhandhmg.allscriptsdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080609000232 CA Practitioner - Family Practice 0143325969 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Colorado School of Medicine, Denver, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

200 W Ctr St Promenade
Anaheim, CA 92805-3960

2280 Harrison Ave
Eureka, CA 95501-3200
Phone (707) 443-9371

2773 Harris St
Eureka, CA 95503-4866

500 Doyle Park Dr
Santa Rosa, CA 95405-4559

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions112
Removal or shaving of skin growth27
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C52586CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation Family Medicine CurrentSince May 1, 2017 Accepting new patients
Providence Medical Foundation CurrentSince May 1, 2017 Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients
Providence Medical Foundation Family Medicine Past Accepting new patients

Locations

2280 Harrison Ave
Ste B
Eureka, CA 95501
Phone (707) 443-9371

2675 Harris St
Eureka, CA 95503
Phone (707) 269-0644

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

500 Doyle Park Dr
Ste 100
Santa Rosa, CA 95405
Phone (714) 449-4842

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.

Hospital & facility affiliations 5

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": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613347200000",
    "number": "1881601615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 HARRIS STREET",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "95503",
            "telephone_number": "707-443-8335",
            "fax_number": "707-443-7327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2675 HARRIS STREET",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "95503",
            "telephone_number": "707-443-8335",
            "fax_number": "707-443-7327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLST",
        "first_name": "GREGORY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2021-02-15",
        "certification_date": "2021-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "C52586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PACIFICARE PROV #",
            "identifier": "84601413802",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ROCKY MTN HMO PROV #",
            "identifier": "846014138009",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROV #",
            "identifier": "H0615462",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "84601413812",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01355239",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR PROV #",
            "identifier": "080182153",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gregoryholst@sjhhandhmg.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "2675 Harris Street",
            "city": "Eureka",
            "state": "CA",
            "country_code": "US",
            "postal_code": "95503",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Eureka, CA

Sources for this page

Verify at the official NPI Registry.