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PROVIDENCE MEDICAL FOUNDATION
NPI 1205131950
Obstetrics & Gynecology in Napa, CA

Active since January 11, 2011CLIA 05D2313157 · Waiver
1100 TRANCAS ST, SUITE 209, NAPA, CA 94558(707) 251-1850(707) 226-1502 Get Directions Write a Review

NPPES record last updated: December 3, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 3, 2025, May 5, 2021, Sep 11, 2017 (3 updates tracked since 2017).

About Providence Medical Foundation NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROVIDENCE MEDICAL FOUNDATION (NPI 1205131950), doing business as St Joseph Heritage Healthcare, is a healthcare organization registered as an obstetrics & gynecology in Napa, California and active in the NPI registry since January 2011. The organization holds a CLIA Waiver certificate valid through October 24, 2026 and lists Donald W. Anderson, Assistant Secretary Of Enrollments, as its authorized official.

NPPES Registry Identity

NPI1205131950
Entity TypeOrganization
Primary Taxonomy207V00000X
Legal Business NamePROVIDENCE MEDICAL FOUNDATION
Location Address1100 TRANCAS ST, SUITE 209Napa, CA 94558-2900
Mailing AddressPo Box 31001 - 1920Pasadena, CA 91110-1920 · (714) 449-4800 · Fax (714) 449-4956
Phone(707) 251-1850
Fax(707) 226-1502
Organization SubpartNo
Authorized OfficialDonald W. AndersonAssistant Secretary Of Enrollments · (425) 358-9786
Enumeration DateJanuary 11, 2011
Last NPPES UpdateDecember 3, 20253 updates tracked since enumeration
NPPES CertifiedDecember 3, 2025
✔ NPI 1205131950 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
1100 TRANCAS ST, Napa, CA 94558
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Other Names 2

Former Legal Business NameSt Joseph Heritage Healthcare
Former Legal Business NameSt Jude Hospital Yorba Linda

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Providence Medical Foundation is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

1,692

Medicare enrollment records show 1,692 clinicians reassign Medicare billing to Providence Medical Foundation, which bills Medicare for the services they deliver. Of these, 16 practice at this address and 47 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 61

Nurse Practitioner274
Internal Medicine234
Family Practice232
Pediatric Medicine79
Emergency Medicine73
Hospitalist64
Obstetrics/Gynecology63
Cardiovascular Disease (Cardiology)62
53 other specialties611

Nearest to this location (20)

See all 1,692
Heather Maine, FNP-BC
Nurse Practitioner
NPI 1689472342
1100 TRANCAS ST STE 201
Napa, CA 94558
(707) 703-4863
✔ PECOS✔ Accepts MedicareSame address
Maria Montenegro-Barreto, M.D.
Family Practice
NPI 1992719199
1100 TRANCAS ST STE 256
Napa, CA 94558
(707) 703-4863
✔ PECOS✔ Accepts MedicareSame address
Muhammad Sheikh, M.D
Family Practice
NPI 1235252859
1100 TRANCAS ST STE 201
Napa, CA 94558
(707) 703-4863
✔ PECOS✔ Accepts MedicareSame address
Abhijit Adhye, M.D.
Internal Medicine
NPI 1992763205
1100 TRANCAS ST STE 211
Napa, CA 94558
(707) 637-4108
✔ PECOS✔ Accepts MedicareSame address
Jennifer Alicbusan, FNP
Nurse Practitioner
NPI 1619435815
1100 TRANCAS ST STE 205
Napa, CA 94558
(707) 251-3604
✔ PECOS✔ Accepts MedicareSame address
Herbert Bazron, MD
Internal Medicine
NPI 1609803048
1100 TRANCAS ST STE 201
Napa, CA 94558
(707) 703-4863
✔ PECOS✔ Accepts MedicareSame address
Shelby Booker, DO
Obstetrics/Gynecology
NPI 1831626381
1100 TRANCAS ST STE 209
Napa, CA 94558
(707) 251-1851
✔ PECOS✔ Accepts MedicareSame address
Ana Espitia, RN, NP
Nurse Practitioner
NPI 1598159808
1100 TRANCAS ST STE 250
Napa, CA 94558
(707) 253-1135
✔ PECOS✔ Accepts MedicareSame address
Tejshri Gohel, NP
Nurse Practitioner
NPI 1558828178
1100 TRANCAS ST STE 209
Napa, CA 94558
(707) 251-1851
✔ PECOS✔ Accepts MedicareSame address
Susana Gonzalez, MD
Obstetrics/Gynecology
NPI 1740202506
1100 TRANCAS ST SUITE 209
Napa, CA 94558
(707) 251-1850
✔ PECOS✔ Accepts MedicareSame address
Daniel Hersh, MD
Obstetrics/Gynecology
NPI 1487625133
1100 TRANCAS ST SUITE 209
Napa, CA 94558
(707) 251-1850
✔ PECOS✔ Accepts MedicareSame address
Amanda Holthouse, D.O.
Obstetrics/Gynecology
NPI 1962799700
1100 TRANCAS ST STE 209
Napa, CA 94558
(707) 251-1850
✔ PECOS✔ Accepts MedicareSame address
Daniel Mirda, M.D.
Medical Oncology
NPI 1811963317
1100 TRANCAS ST STE 256
Napa, CA 94558
(707) 253-7161
✔ PECOS✔ Accepts MedicareSame address
Michael Novak, MD
Family Practice
NPI 1972501179
1100 TRANCAS ST STE 250
Napa, CA 94558
(707) 253-1135
✔ PECOS✔ Accepts MedicareSame address
Roger Scarborough, MD
Obstetrics/Gynecology
NPI 1013939875
1100 TRANCAS STREET STE 209
Napa, CA 94558
(707) 251-1850
✔ PECOS✔ Accepts MedicareSame address
Jaime Filtzkowski, APNP
Nurse Practitioner
NPI 1356690549
1100 TRANCAS ST STE 250
Napa, CA 94558
(707) 253-1135
✔ PECOS✔ Accepts MedicareSame address
Mark Borsody, MD
Neurology
NPI 1215179767
1000 TRANCAS ST
Napa, CA 94558
(847) 274-1790
✔ PECOS✔ Accepts Medicare0.1 mi
Eric Lee, M.D.
Hospitalist
NPI 1821520032
1000 TRANCAS ST
Napa, CA 94558
(707) 252-4411
✔ PECOS✔ Accepts Medicare0.1 mi
Amir Razavi, M.D.
Internal Medicine
NPI 1063457059
1000 TRANCAS ST
Napa, CA 94558
(707) 251-3518
✔ PECOS✔ Accepts Medicare0.1 mi
Stacy James, RN, MSN, ACNP-BC
Nurse Practitioner
NPI 1265515340
1000 TRANCAS ST
Napa, CA 94558
(707) 252-4411
✔ PECOS✔ Accepts Medicare0.1 mi
See all 1,692 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2313157

Providence Medical Foundation · Napa, CA
Active · expires Oct 24, 2026
CLIA Number05D2313157
Laboratory TypePhysician Office
Certificate Effective DateOctober 25, 2024
Certificate Expiration DateOctober 24, 2026
Laboratory DirectorElse Jensen
Laboratory Phone(707) 703-4863
Laboratory LocationProvidence Medical Foundation1100 Trancas St, Suite 201, Napa, CA 94558
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Providence Medical Foundation's NPI number?

The NPI number for Providence Medical Foundation is 1205131950. It was assigned to this organization in the NPPES registry on January 11, 2011. The provider was formerly known as St Joseph Heritage Healthcare and St Jude Hospital Yorba Linda.

Where is Providence Medical Foundation located?

Providence Medical Foundation is located at 1100 Trancas St Suite 209, Napa, CA 94558. The listed phone number is (707) 251-1850.

What is Providence Medical Foundation's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Is Providence Medical Foundation enrolled in Medicare?

Yes. Providence Medical Foundation is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Providence Medical Foundation?

According to the CMS Revalidation Reassignment List (October 2026 release), 1,692 clinicians in 61 Medicare specialties reassign their Medicare billing to Providence Medical Foundation. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (274), Internal Medicine (234) and Family Practice (232). Of these, 16 practice at this address and 47 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Providence Medical Foundation hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2313157) is associated with this NPI, valid through October 24, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Providence Medical Foundation was last updated on December 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.