MADIGAN ARMY MEDICAL CTR (NPI# 1255537510) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255537510 |
| Entity Type | Organization |
| Organization Name | MADIGAN ARMY MEDICAL CTR |
| Other Organization Name | USADC PRESIDIO OF MONTERREY |
| Practice Address |
473 Cabrillo St Bldg 422 Monterey CA 93944-3201 |
| Mailing Address |
9040a Jackson Ave Attn: Mchj-csa-u Tacoma WA 98431-0001 |
| Practice Telephone | 8312425612 |
| Mailing Telephone | 2539686598 |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2015-04-13 |
| Authorized Official Name | KAREN MADY (TPC MANAGER) |
| Authorized Official Telephone | 2539686598 |
| Is Organization Subpart | Y |
| Parent Organization Name | MADIGAN ARMY MEDICAL CTR |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1100X |
Clinic/Center Specialization: Military/U.S. Coast Guard Outpatient |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| USADC PRESIDIO OF MONTERREY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770975583 | Madigan Army Medical Ctr | Clinic/Center | Railroad Ave Bldg R3749, Tacoma, WA 98431-0001 | 2015-03-03 |
| 1528488848 | Madigan Army Medical Ctr | Military/U.S. Coast Guard Pharmacy | Madigan Army Medical Ctr 9040, Jackson Ave, Tacoma, WA 98431-1100 | 2014-04-25 |
| 1376974303 | Madigan Army Medical Ctr | Clinic/Center | 3 Rd Division Dr Bldg R3150, Tacoma, WA 98431-0001 | 2013-12-02 |
| 1588094213 | Madigan Army Medical Ctr | Clinic/Center | C St Bldg R1880, Tacoma, WA 98431-0001 | 2013-11-15 |
| 1043640774 | Madigan Army Medical Ctr | Clinic/Center | Railroad Ave Bldg R3742, Tacoma, WA 98431-0001 | 2013-11-15 |
| 1750719761 | Madigan Army Medical Ctr | Clinic/Center | 5 Th St Bldg 9025, Tacoma, WA 98431-0001 | 2013-10-30 |
| 1801152723 | Madigan Army Medical Ctr | Clinic/Center | 13815 8th St, Joint Base Lewis Mcchord, WA 98431-0001 | 2012-04-04 |
| 1316243744 | Madigan Army Medical Ctr | Military/U.S. Coast Guard Pharmacy | 10507 156th St E, Suite 112, Puyallup, WA 98374-9361 | 2011-02-02 |
| 1851605356 | Madigan Army Medical Ctr | Clinic/Center | 15600 Meridan Ave, Sunrise Village Center, East Puyallup, WA 98374 | 2010-07-27 |
| 1881907822 | Madigan Army Medical Ctr | Clinic/Center | 3415 Pacific Ave Se, Suite D1, Olympia, WA 98501-2173 | 2010-07-20 |
| Street Address |
473 CABRILLO ST BLDG 422 |
| City | MONTEREY |
| State | CA |
| Zip Code | 93944-3201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609849983 | Kirsten Marie Anke | Registered Nurse | 473 Cabrillo St, Suite A1a, Monterey, CA 93944-3201 | 2006-02-08 |
| 1467990036 | Christopher Mendez | Radiologic Technologist | 473 Cabrillo St, Building 422, Monterey, CA 93944-3201 | 2017-02-03 |
| 1952681389 | Kathryn Elizabeth King | Pharmacist | 473 Cabrillo St, Bldg 422, Monterey, CA 93944-3201 | 2011-08-17 |
| 1902123243 | Monterey Army Health Clinic (pomahc) | Pharmacy | 473 Cabrillo St, A-102, Monterey, CA 93944-3201 | 2010-04-27 |
| 1093045668 | Marion Virgil Sanders Iv | Physician Assistant | 473 Cabrillo St, Army Health Clinic/517th Trg, Monterey, CA 93944-3201 | 2010-01-05 |
| 1043488232 | Cheryl Ann Hastings | Registered Nurse | 473 Cabrillo St, Monterey, CA 93944-3201 | 2008-02-11 |
| 1316092968 | Daniel I Mirski | Emergency Medicine | 473 Cabrillo St, Monterey, CA 93944-3201 | 2007-01-24 |
| 1740390616 | Larry Everett Norton | Family Medicine | 473 Cabrillo St, Suite A1a, Monterey, CA 93944-3201 | 2006-08-30 |
| 1992716740 | Andrew Wodecki | Optometrist | 473 Cabrillo St, Suite A1a, Monterey, CA 93944-3201 | 2006-08-10 |
| 1801859756 | Flora Raymundo Dela Pena | Registered Nurse | 473 Cabrillo St, Monterey, CA 93944-3201 | 2006-04-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902237704 | Robert Sawyer | Family Medicine | Persidio of Monterey Army Health Clinic, 473 Cabrillo Street, Bldg 422, Monterey, CA 93944 | 2013-12-03 |
| 1841458452 | Matthew Scott Douglas | Physician Assistant | 473 Cabrillo Ave, Bldg 422, Presidio of Monterey Army Health Clinic, Monterey, CA 93944 | 2008-05-30 |
| 1205898871 | Madigan Army Medical Center | Social Worker | 437 Cabrillo St, Suite Aia -us Army Health Clinic, Presido of Monterey, CA 93944 | 2006-04-06 |
| 1982677175 | Eric D Morgan | Family Medicine | Presidio of Monterey Army Health Clinic, 473 Cabrillo St, Presidio of Monterey, CA 93944 | 2006-02-09 |
| 1083685358 | Andre Ming Wong | Dentist | 423 Cpl Evans Rd, Pom Dental Clinic Cmd, Monterey, CA 93944 | 2006-01-27 |
| 1912978248 | Russel Kyle Catterlin Jr. | Dentist | 423 Corporal Evans Road, Presidio of Monterey Dental Clinic, Monterey, CA 93944 | 2006-01-26 |
| 1477904191 | Teddie Matthews | Dental Hygienist | 423 Cpl Evans Rd, Monterey, CA 93944 | 2016-06-23 |
| 1467559781 | Kathleen Elizabeth Martin | Social Worker | 473 Cabrillo Street, Ste. 422, Presidio of Monterey Army Health Clinic, Monterey, CA 93944-0001 | 2006-09-20 |
| 1013909506 | Jon Richard Tabije | Psychologist | California Medical Detachment, Presidio of Monterey, Building 422, Monterey, CA 93944-0001 | 2005-08-19 |
| 1588853816 | Tracey Earnette Powell | Military Hospital | 473 Cabrillo St # B422, Monterey, CA 93944-3201 | 2007-10-23 |
| Find all providers in zip 93944 | ||||
| Taxonomy Code | 261QM1100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Military/U.S. Coast Guard Outpatient |
| The Defense Health Program or U.S. Coast Guard funded "fixed" facilities or distinct parts of a facility, providing outpatient medical and dental services, primarily for Uniformed Services beneficiaries. A "fixed" facility is a non-temporary, non-deployed facility. It includes mobile specialty units such as Magnetic Resonance Imaging (MRI) units that may furnish services at the "fixed" facility. It includes, as examples, the institutional portion of outpatient encounters (except Ambulatory Procedure Visits), supplies issued (e.g., glasses, ostomy supplies, crutches), and radiology and laboratory studies. Does not include items issued directly to a patient from an outpatient pharmacy or patient transport. |
| Notes: Source: TRICARE Management Activity Uniform Business Office User’s Guide [1/1/2005: title modified, definition added; 7/1/2006 title modified, definition modified] |
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| 1790179455 | Naval Hospital Camp Pendleton | Clinic/Center | 41 Area Branch Medical Clinic, Bldg 414006, Camp Pendleton, CA 92055 | 2015-03-20 |
| 1245624907 | Branch Medical Clinic Area 43 | Clinic/Center | 43 Area Branch Medical Clinic, Bldg 434057, Camp Pendleton, CA 92055 | 2015-03-20 |
| 1154715811 | Branch Medical Clinic Area 53 | Clinic/Center | 53 Area Branch Medical Clinic, Bldg 533020, Camp Pendleton, CA 92055 | 2015-03-20 |
| 1801288634 | Branch Medical Clinic Nalf San Clemente Island | Clinic/Center | Wilson Cove, Bldg 60126, San Clemente, CA 92135 | 2015-03-03 |
| 1023400256 | Branch Medical Clinic Mcas Miramar | Clinic/Center | Bauer Rd, Bldg 2496, San Diego, CA 92145-0001 | 2015-02-25 |
| 1083028989 | Weed Army Community Hospital | Clinic/Center | Bldg 189 Ave B, Fort Irwin, CA 92310 | 2014-06-18 |
| 1891109799 | Weed Army Community Hospital | Clinic/Center | Ave B Bldg R190, Warrior Care Center, Fort Irwin, CA 92310 | 2014-06-18 |
| 1871832394 | Branch Medical Clinic Area 62 | Clinic/Center | Bldg 620306 8th Street, Camp Pendleton, CA 92055 | 2013-02-04 |
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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.