North Coast Medical Center Inc

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

License

G085353 Issued in CA

Legal business name

NORTH COAST MEDICAL CENTER INC

Practice address

2465 Summerfield Rd
Santa Rosa, CA 95405-7815

Phone

(707) 546-7979

Fax

(707) 546-7667

NPI assigned

Jun 26, 2007

Last updated

Jun 8, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michael L Tran, MDNPI 1013927110

Title

Owner Doctor

Phone

(707) 546-7979

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Dr Michael Tran MD Other name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1932305968. Details of each certification follow.

• CCN 05C0001887 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 05C0001887

Legal name

NORTH COAST MEDICAL CENTER, INC

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Jan 13, 2009

Last certification

Jan 13, 2009

Ownership / control type

Proprietary

Facility address

2465 Summerfield Road
Santa Rosa, CA 95405

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 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Long Tran, MD

  • Anesthesiology Physician
  • Santa Rosa, CA
  • NPI 1013927110
  NPD (past) Authorized official
• Norman Pang, MD

  • Pain Medicine (Anesthesiology) Physician
  • Petaluma, CA
  • NPI 1861434367
  NPD (past)

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433721600000",
    "number": "1932305968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4704 HOEN AVENUE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "95405",
            "telephone_number": "707-546-7979",
            "fax_number": "707-546-7667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2465 SUMMERFIELD RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954057815",
            "telephone_number": "707-546-7979",
            "fax_number": "707-546-7667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH COAST MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-26",
        "last_updated": "2015-06-08",
        "status": "A",
        "authorized_official_last_name": "TRAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER DOCTOR",
        "authorized_official_telephone_number": "707-546-7979",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "CA",
            "license": "G085353",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "159045000",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr Michael Tran MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Northern California Medical Assoc
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• Northern California Medical Assoc Inc

• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.