Dignity Health Medical Foundation

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

DIGNITY HEALTH MEDICAL FOUNDATION

Practice address

3427 Robin LN
Suite 100
Cameron Park, CA 95682-7255

Phone

(530) 676-7337

Fax

(530) 676-1141

NPI assigned

Nov 25, 2009

Organization subpart

Yes

Parent organization

DIGNITY HEALTH MEDICAL FOUNDATIONAs reported in NPPES

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

Addresses

Other names 1

• Mercy Medical Group, a service of Dignity Health Medical Foundation Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Part of

Woodland Clinic Med GRP

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

CLIA laboratory certificates

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

{
    "created_epoch": "1259107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605657600000",
    "number": "1922336296",
    "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": "3427 ROBIN LN",
            "address_2": "SUITE 100",
            "city": "CAMERON PARK",
            "state": "CA",
            "postal_code": "956827255",
            "telephone_number": "530-676-7337",
            "fax_number": "530-676-1141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIGNITY HEALTH MEDICAL FOUNDATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DIGNITY HEALTH MEDICAL FOUNDATION",
        "enumeration_date": "2009-11-25",
        "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"
        }
    ]
}

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• All providers in Cameron Park, CA
• Multi-Specialty Clinic/Center in California

• 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.

Verify at the official NPI Registry.