Purisima Family Medicine, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PURISIMA FAMILY MEDICINE, INC.

Practice address

575 Kelly St
Half Moon Bay, CA 94019-1719

Phone

(650) 288-0508

Fax

(650) 713-0535

NPI assigned

Jun 11, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Daniel Eugene McMillan, M.D.NPI 1588692107

Title

President

Phone

(650) 288-0508

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Daniel Eugene McMillan, M.D.

  • Family Medicine Physician
  • Half Moon Bay, CA
  • NPI 1588692107
  Medicare reassignment Care Compare group NPD Authorized official
• Jill Kathleen Pavliscak, M.D.

  • Family Medicine Physician
  • Half Moon Bay, CA
  • NPI 1144258765
  Medicare reassignment Care Compare group NPD
• Lala Corina Rodriguez, PA-C

  • Physician Assistant
  • Sunnyvale, CA
  • NPI 1316350796
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1244678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244678400000",
    "number": "1881821387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 277",
            "city": "HALF MOON BAY",
            "state": "CA",
            "postal_code": "940190277",
            "telephone_number": "650-288-0508",
            "fax_number": "650-713-0535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 KELLY ST",
            "city": "HALF MOON BAY",
            "state": "CA",
            "postal_code": "940191719",
            "telephone_number": "650-288-0508",
            "fax_number": "650-713-0535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURISIMA FAMILY MEDICINE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-11",
        "last_updated": "2009-06-11",
        "status": "A",
        "authorized_official_last_name": "MCMILLAN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "650-288-0508",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra Lynn Perez, NP
• Emma Petree
• Khoa Dang Pham, RPH
• Svitlana Plaschke, NP
• Katherine Mihalov Prescenzi, L.AC. , MSTCM, DACM
• Damaris Andrews Pyle, LMFT
• Charles Frederick Quest Jr., MD
• Melvin Jay Rabeck, PH.D.
• Hana Renor, C.F.N.P.
• Elizabeth Helena Robertson, RDH, RDA

• Family Medicine Physician in Half Moon Bay, CA
• Providers in Half Moon Bay, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2009; 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.

Verify at the official NPI Registry.