DIGNITY HEALTH MEDICAL FOUNDATION (NPI# 1912031477) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912031477 |
| Entity Type | Organization |
| Organization Name | DIGNITY HEALTH MEDICAL FOUNDATION |
| Other Organization Name | MERCY MEDICAL GROUP, A SERVICE OF DIGNITY HEALTH MEDICAL FOUNDATION |
| Practice Address |
2110 Professional Dr Suite 120 Roseville CA 95661-3752 |
| Mailing Address |
Po Box 60000 File #72938 San Francisco CA 94160-2938 |
| Practice Telephone | 9165362500 |
| Practice Fax Number | 9167803904 |
| Mailing Telephone | 9167335336 |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2014-12-17 |
| Authorized Official Name | GEORGE LENZI (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 9168512559 |
| Is Organization Subpart | Y |
| Parent Organization Name | DIGNITY HEALTH MEDICAL FOUNDATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| HEALTH NET | 983 | 01 | |
| BLUE SHIELD | ZZZ28398Z | 01 | |
| HEALTH NET | 195 | 01 | |
| DME SUPPLIER # | 476040023 | 01 | |
| SPECIAL PURPOSE TAX ID # | 341996544 | 01 | |
| BLUE CROSS | KYX | 01 | |
| CA | GR0050152 | 05 | |
| BLUE SHIELD | ZZZ29433Z | 01 | |
| CIGNA | 0019838 | 01 |
| Other Name | Type Code |
|---|---|
| Mercy Medical Group, a service of Dignity Health Medical Foundation | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710129275 | Dignity Health Medical Foundation | Clinic/Center | 105 Dean Way, Folsom, CA 95630-2801 | 2009-03-30 |
| 1447492905 | Dignity Health Medical Foundation | Clinic/Center | 6060 Watt Ave, North Highlands, CA 95660-4212 | 2009-03-30 |
| 1366684821 | Dignity Health Medical Foundation | Clinic/Center | 10487 White Rock Rd, Rancho Cordova, CA 95670-5530 | 2009-03-30 |
| 1558495937 | Dignity Health Medical Foundation | Clinic/Center | 7911 Laguna Blvd, Elk Grove, CA 95758-7920 | 2007-03-15 |
| 1780226852 | Dignity Health Medical Foundation | Clinic/Center | 17051 Sierra Lakes Pkwy Ste 101, Fontana, CA 92336-1274 | 2019-10-10 |
| 1568989200 | Dignity Health Medical Foundation | Clinic/Center | 3400 Data Dr, Rancho Cordova, CA 95670-7956 | 2017-08-24 |
| 1477074474 | Dignity Health Medical Foundation | Clinic/Center | 3400 Data Dr, Rancho Cordova, CA 95670-7956 | 2017-06-29 |
| 1679019798 | Dignity Health Medical Foundation | Clinic/Center | 6615 Valley Hi Dr, Sacramento, CA 95823-7076 | 2017-01-12 |
| 1508222647 | Dignity Health Medical Foundation | Clinic/Center | 18406 Roscoe Blvd, Northridge, CA 91325-4107 | 2016-01-05 |
| 1376926527 | Dignity Health Medical Foundation | Clinic/Center | 17051 Sierra Lakes Pkwy, Suite 101, Fontana, CA 92336-1274 | 2015-07-07 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | DIGNITY HEALTH MEDICAL FOUNDATION | 3400 Data Dr, Rancho Cordova, CA 95670-7956 |
| Street Address |
2110 PROFESSIONAL DR SUITE 120 |
| City | ROSEVILLE |
| State | CA |
| Zip Code | 95661-3752 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861466971 | Zaradhe Yach | Nurse Practitioner | 2110 Professional Dr, Suite 120, Roseville, CA 95661-3752 | 2006-02-15 |
| 1396195483 | Shikha Rathi- Raythatha | Dentist | 2110 Professional Dr, Suite 101, Roseville, CA 95661-3752 | 2016-06-20 |
| 1740693894 | Karla Lu Houskeeper | Nurse Practitioner | 2110 Professional Dr, St 120, Roseville, CA 95661-3752 | 2014-06-06 |
| 1891074423 | Neda Raheen | Physician Assistant | 2110 Professional Dr, Suite 120, Roseville, CA 95661-3752 | 2011-08-13 |
| 1982995825 | Namrita Gogia | Internal Medicine | 2110 Professional Dr, Suite 120, Roseville, CA 95661-3752 | 2011-04-26 |
| 1013247238 | David Zuccolotto | Psychologist | 2110 Professional Dr, Suite 120, Roseville, CA 95661-3752 | 2010-01-11 |
| 1386811230 | Sacramento Radiology Medical Group, Inc. | Radiology | 2110 Professional Dr, Suite 190, Roseville, CA 95661-3752 | 2008-05-09 |
| 1861593402 | Kenneth L. Corbin | Family Medicine | 2110 Professional Dr, Suite 120, Roseville, CA 95661-3752 | 2006-09-26 |
| 1538266499 | Siamak Okhovat | Dentist | 2110 Professional Dr, Suite 115, Roseville, CA 95661-3752 | 2006-09-20 |
| 1982716205 | Terri E. Bigler | Internal Medicine | 2110 Professional Dr, Suite 120, Roseville, CA 95661-3752 | 2006-08-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134777816 | Aprildawn Mccarty Mccarty | Behavior Technician | 2125 Professional Dr, 100, Roseville, CA 95661 | 2019-08-27 |
| 1407409089 | David Armel Gomez Croddy | Dentist | 2740 Carradale Drive, Roseville, CA 95661 | 2019-07-22 |
| 1699335612 | Mowell | Durable Medical Equipment & Medical Supplies | 901 Sunrise, Roseville, CA 95661 | 2019-06-20 |
| 1578024998 | Mystesia Lasan Hayes | Behavior Technician | 4121 Vittorio Dr., Roseville, CA 95661 | 2019-03-28 |
| 1033676457 | The Place Within | Counselor | 720 Sunrise Ave #d115, Roseville, CO 95661 | 2019-02-21 |
| 1396217733 | Tuyen Thi Thanh Nguyen | Respiratory Therapist, Registered | Kaiser Roseville Hospital, 1600 Eureka Rd, Roseville, CA 95661 | 2018-12-26 |
| 1982179776 | Dr. Jeffrey A. Saladin, Dental Corporation | Dentist | 1565 Eureka Road, Suite 5, Roseville, CA 95661 | 2018-10-08 |
| 1184106536 | Sabita Kondle | Marriage & Family Therapist | 1528 Hope Counseling Center Ste 101, Roseville, CA 95661 | 2018-09-02 |
| 1740787837 | Sylvia A Atieno | Nurse Practitioner | Suttter Roseville Medical Center, 1 Medical Plaza, Roseville, CA 95661 | 2018-04-06 |
| 1457875296 | Good Works Psychophysiology and Physical Therapy | Physical Therapist | 1650 Leadhill Blvd, 600, Roseville, CA 95661 | 2017-08-02 |
| Find all providers in zip 95661 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902219595 | Rosenberg Center: Assessment and Treatment for Children and Families | Clinic/Center | 1935 County Road B2 W, Suite 100, Roseville, MN 55113-2729 | 2014-06-11 |
| 1932477874 | Physicians Network Medical Group Inc | Clinic/Center | 2100 Douglas Blvd, Roseville, CA 95661-3804 | 2011-12-07 |
| 1144200775 | Regents of The University of California | Clinic/Center | 2261 Douglas Blvd, Roseville, CA 95661-3831 | 2006-01-19 |
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| 1134738032 | Healthworks Med Group of California A Medical Corporation | Clinic/Center | 2821 Scott Blvd Ste 2126, Santa Clara, CA 95050-2549 | 2020-07-27 |
| 1437767951 | Miro Health | Clinic/Center | 260 King St Unit 1505, San Francisco, CA 94107-6415 | 2020-07-21 |
| 1598383895 | Alacrity Patient Services, Inc. | Clinic/Center | 1002 N Hudson Ave Apt 1, Los Angeles, CA 90038-2595 | 2020-07-13 |
| 1306464979 | Aleracare Medical Group of California | Clinic/Center | 4849 Van Nuys Blvd Ste 220, Sherman Oaks, CA 91403-2155 | 2020-07-10 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.