NPIMap

Organization Active NPI

Medxcare Health Professionals

  • Physical Medicine & Rehabilitation Physician
  • Santa Cruz, CA
National Provider Identifier
1982177150
Registry record updated Jan 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
MEDXCARE HEALTH PROFESSIONALS
Practice address
149 Josephine St Ste a
Santa Cruz, CA 95060-2775
Phone
(831) 200-4217
NPI assigned
Jan 9, 2019
Last updated
Jan 9, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2019

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

Authorized official

Name
Mike Ellison
Title
Chief Operations Officer
Phone
(831) 200-4217

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X
Registered DietitianGroup: 193200000X MULTI-SPECIALTY GROUP 133V00000X
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X Primary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X

Addresses

Primary practice location

149 Josephine St Ste a
Santa Cruz, CA 95060-2775

Mailing address

149 Josephine St Ste a
Santa Cruz, CA 95060-2775

Other practice location 1

50 Penny Ln
Watsonville, CA 95076-3079
Phone (831) 200-4217

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230823003335 CA Part B Supplier - Clinic/Group Practice 1658734645 Receives reassigned benefits from 9 practitioners
Practice locations: Santa Cruz, CA

National Provider Directory

National Provider Directory

Locations

149 Josephine St
Ste A
Santa Cruz, CA 95060
Phone (831) 200-4217

317 Potrero St
Ste C
Santa Cruz, CA 95060
Phone (831) 425-9500

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1546992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546992000000",
    "number": "1982177150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 JOSEPHINE ST STE A",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950602775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 JOSEPHINE ST STE A",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950602775",
            "telephone_number": "831-200-4217"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 Penny Ln",
            "address_purpose": "LOCATION",
            "city": "Watsonville",
            "state": "CA",
            "postal_code": "950763079",
            "country_code": "US",
            "telephone_number": "831-200-4217",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MEDXCARE HEALTH PROFESSIONALS",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-09",
        "last_updated": "2019-01-09",
        "status": "A",
        "authorized_official_last_name": "ELLISON",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "CHIEF OPERATIONS OFFICER",
        "authorized_official_telephone_number": "831-200-4217"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Jan 9, 2019; 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.