Ez Sleep Club, Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

EZ SLEEP CLUB, INC.

Doing business as

Modesto Sleep Center Diagnostic

Practice address

5039 Pentecost Dr Ste D
Modesto, CA 95356-9290

Phone

(888) 588-0202

Fax

(888) 599-0202

NPI assigned

Feb 4, 2017

Organization subpart

No

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

Authorized official

Name

Mrs. Andrea Marie Ewert

Title

Ceo

Phone

(209) 523-0202

Specialties & licenses 2

Addresses

Other names 1

• Modesto Sleep Center Diagnostic Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Tax ID family

Ez Sleep Club Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Ez Sleep Club, Inc.

  • Sleep Disorder Diagnostic Clinic/Center
  • Merced, CA
  • NPI 1477496289
  NPD tax ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Ez Sleep Club, Inc.

  • Sleep Disorder Diagnostic Clinic/Center
  • Merced, CA
  • NPI 1477496289
  NPPES parent name

Practitioners 1

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

• Siraj K Ahmed, M.D.

  • Pulmonary Disease Physician
  • Manteca, CA
  • NPI 1265513121
  NPD

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

{
    "created_epoch": "1486166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710806400000",
    "number": "1952849499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 578104",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953578104",
            "telephone_number": "888-588-0202",
            "fax_number": "888-599-0202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5039 PENTECOST DR STE D",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569290",
            "telephone_number": "888-588-0202",
            "fax_number": "888-599-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EZ SLEEP CLUB, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-04",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A",
        "authorized_official_last_name": "EWERT",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "209-523-0202",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QS1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Sleep Disorder Diagnostic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Modesto Sleep Center Diagnostic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Modesto Sleep Center Diagnostic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinical Medical Laboratory in Modesto, CA
• Providers in Modesto, CA by specialty
• Clinical Medical Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.