Organization Active NPI

Central Coast Oncology & Hematology

  • Medical Oncology Physician
  • Santa Cruz, CA
National Provider Identifier
1942473491
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
Legal business name
CENTRAL COAST ONCOLOGY & HEMATOLOGY
Practice address
1669 Dominican Way
Santa Cruz, CA 95065-1523
Phone
(831) 475-2220
Fax
(831) 475-2221
NPI assigned
Apr 4, 2008
Last updated
Jun 21, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Authorized official

Name
Michael Yen, MDNPI 1437269313
Title
Owner
Phone
(831) 475-2220

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology Physician 207RX0202X Primary

Addresses

Primary practice location

1669 Dominican Way
Santa Cruz, CA 95065-1523

Mailing address

1669 Dominican Way
Santa Cruz, CA 95065-1523
Phone (831) 475-2220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081009000397 CA Part B Supplier - Clinic/Group Practice 0143398735 Receives reassigned benefits from 3 practitioners
Practice locations: Santa Cruz, CA

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D1083014Central Coast Oncology & Hematology1669 Dominican Way, Santa Cruz, CA 95065ComplianceFeb 10, 2027

National Provider Directory

National Provider Directory

Locations

1669 Dominican Way
Santa Cruz, CA 95065
Phone (408) 462-1000

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1207267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1942473491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1669 DOMINICAN WAY",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651523",
            "telephone_number": "831-475-2220",
            "fax_number": "831-475-2221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1669 DOMINICAN WAY",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651523",
            "telephone_number": "831-475-2220",
            "fax_number": "831-475-2221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL COAST ONCOLOGY & HEMATOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-04",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "YEN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "831-475-2220",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.