NORTH BAY MEDICAL GROUP SURGERY CENTER (NPI# 1639220189) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639220189 |
| Entity Type | Organization |
| Organization Name | NORTH BAY MEDICAL GROUP SURGERY CENTER |
| Practice Address |
4415 Sonoma Hwy Suite B Santa Rosa CA 95409-7100 |
| Mailing Address |
3850 Montgomery Dr Suite D Santa Rosa CA 95405-5207 |
| Practice Telephone | 7075910619 |
| Practice Fax Number | 7075910617 |
| Mailing Telephone | 7075910619 |
| Mailing Fax Number | 7075910617 |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2008-07-21 |
| Authorized Official Name | ERIC JAMES KRAUT (PRESIDENT) |
| Authorized Official Telephone | 7075910619 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
AS1628 | CA | Ambulatory Health Care Facilities |
| Street Address |
4415 SONOMA HWY SUITE B |
| City | SANTA ROSA |
| State | CA |
| Zip Code | 95409-7100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225036320 | David John Martin | Urology | 4415 Sonoma Hwy, Suite A, Santa Rosa, CA 95409-7100 | 2005-07-12 |
| 1780073957 | Adventist Health Physicians Network | Clinic/Center | 4415 Sonoma Hwy, Suite D, Santa Rosa, CA 95409-7100 | 2015-01-12 |
| 1275710006 | Chico Feminist Women's Health Center | Clinic/Center | 4415 Sonoma Hwy, Suite D, Santa Rosa, CA 95409-7100 | 2008-01-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568005205 | Angela Tejeda | Counselor | 35555 Sonoma Hwy, Santa Rosa, CA 95409 | 2019-10-25 |
| 1609335314 | Heidi Diebel | Marriage & Family Therapist | 9291 Oak Trail Cir, Santa Rosa, CA 95409 | 2019-03-13 |
| 1427525328 | Christopher William Schouest | Behavioral Analyst | 5424 Sharon St., Santa Rosa, CA 95409 | 2018-10-29 |
| 1194178756 | Ana Ceniceros | Registered Nurse | 7425 Los Guilucos Rd, Santa Rosa, CA 95409 | 2016-07-19 |
| 1669842878 | Kimberly Harris | Counselor | 7425 Los Guilicos Rd., Dept. H, Santa Rosa, CA 95409 | 2015-09-30 |
| 1568884849 | Christopher Cincotta | Counselor | 540 Middle Rincon Road, Santa Rosa, CA 95409 | 2014-01-06 |
| 1104186626 | Gina Ruth Sarpy | Marriage & Family Therapist | 7425 Los Guilicos Rd, Dept. H, Santa Rosa, CA 95409 | 2012-05-17 |
| 1467745950 | Courtney King | Family Medicine | 4702 Starbuck Ave, Santa Rosa, CA 95409 | 2011-05-17 |
| 1427351162 | Robert E Richardson Md Professional Corp. | Surgery | 1812 Happy Valley Road, Santa Rosa, CA 95409 | 2010-12-20 |
| 1497063564 | Edmundo Simon Martinez IIi IIi | Occupational Therapist | 5555 Montgomery Dr., Santa Rosa, CA 95409 | 2010-09-22 |
| Find all providers in zip 95409 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356888705 | Webster Surgery Center, Lp | Clinic/Center | 730 Bennett Valley Road, Santa Rosa, CA 95404 | 2017-01-24 |
| 1063646594 | Advanced Surgery Institute, LLC | Clinic/Center | 1739 4th St, Santa Rosa, CA 95404-3601 | 2009-05-12 |
| 1215002852 | Santa Rosa Ambulatory Surgical Center Medical Group Inc | Clinic/Center | 76 Brookwood Ave Ste B, Santa Rosa, CA 95404-4312 | 2006-11-21 |
| 1922197987 | Chernoff and Associates Cosmetic Surgeons | Clinic/Center | 830 2nd St, Santa Rosa, CA 95404-4620 | 2006-10-11 |
| 1831200815 | Novamed Surgery Center of Santa Rosa, LLC | Clinic/Center | 1720 4th St, Santa Rosa, CA 95404-3602 | 2006-08-31 |
| 1457317398 | Santa Rosa Surgery Center Lp | Clinic/Center | 34 Mark West Springs Rd Suite 100, Santa Rosa Surgery and Endoscopy Center, Santa Rosa, CA 95403-1436 | 2006-04-20 |
| 1811242563 | Sutter West Bay Medical Foundation | Clinic/Center | 1200 Sonoma Ave, Ste 2, Santa Rosa, CA 95405-6664 | 2012-07-18 |
| 1386966935 | Norcal Specialty Surgery Center, LLC | Clinic/Center | 730 Bennett Valley Rd, Santa Rosa, CA 95404-5514 | 2010-02-24 |
| 1295878874 | The Surgery Suite | Clinic/Center | 4625 Quigg Dr, Santa Rosa, CA 95409-5377 | 2007-02-14 |
| 1538201587 | Plastic Surgery Associates | Clinic/Center | 4625 Quigg Dr, Santa Rosa, CA 95409-5377 | 2007-02-13 |
| Find all providers in SANTA ROSA | ||||
| City | SANTA ROSA |
| Zip Code | 95409 |
Please comment or provide details below to improve the information on NORTH BAY MEDICAL GROUP SURGERY CENTER.
| 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.