NPIMap

Individual provider Active NPI

Marie Claudette Decastro Grageda, MD

  • Family Medicine Physician
  • Hollister, CA
National Provider Identifier
1891998159
Registry record updated Oct 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A98158 Issued in CA
Practice address
930 Sunnyslope Rd Ste E3
Hollister, CA 95023-5638
Phone
(831) 636-7494
Fax
(831) 636-7496
NPI assigned
Jun 6, 2007
Last updated
Oct 18, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2007

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 A98158 CA Primary

Addresses

Primary practice location

930 Sunnyslope Rd Ste E3
Hollister, CA 95023-5638

Mailing address

930 Sunnyslope Rd Ste E3
Hollister, CA 95023-5638
Phone (831) 636-7494

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
I20081107000340 CA Practitioner - Family Practice 3577622315 Reassigns benefits to 1 organization
Practice locations: Hollister, CA

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

930 Sunnyslope Rd
C1
Hollister, CA 95023-5617
Phone (831) 636-1751

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
98158CAMDMarriage & Family Therapist
A98158CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hazel Hawkins Memorial Hospital CurrentSince Mar 31, 2009 Accepting new patients
Hazel Hawkins Memorial Hospital CurrentSince Mar 31, 2009 Accepting new patients
Cytodiagnostics Current Accepting new patients
Rubicon Orthopaedics and Sports Performance, Inc. Current Accepting new patients
Felicidad G Lao-Domingo MD Inc Past Accepting new patients

Locations

901 Sunset Dr
Ste 4
Hollister, CA 95023
Phone (831) 630-9467

911 Sunset Dr
Hollister, CA 95023
Phone (831) 626-2640

930 Sunnyslope Rd
Ste E3
Hollister, CA 95023
Phone (831) 630-1477

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DFACCA/Endpoint/DFACCA

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 7

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": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192665600000",
    "number": "1891998159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 SUNNYSLOPE RD STE E3",
            "city": "HOLLISTER",
            "state": "CA",
            "postal_code": "950235638",
            "telephone_number": "831-636-7494",
            "fax_number": "831-636-7496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 SUNNYSLOPE RD STE E3",
            "city": "HOLLISTER",
            "state": "CA",
            "postal_code": "950235638",
            "telephone_number": "831-636-7494",
            "fax_number": "831-636-7496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAGEDA",
        "first_name": "MARIE CLAUDETTE",
        "middle_name": "DECASTRO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-06",
        "last_updated": "2007-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A98158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollister, CA

Sources for this page

Verify at the official NPI Registry.