ST NAZARENE MEDICAL CLINIC INC
NPI 1275714917
Clinic/Center - Primary Care in Oxnard, CA
About St Nazarene Medical Clinic Inc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ST NAZARENE MEDICAL CLINIC INC (NPI 1275714917) is a healthcare organization registered as a primary care in Oxnard, California and active in the NPI registry since November 2007. The organization holds a CLIA Waiver certificate valid through July 27, 2027 and lists Suzanne L Fussell, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
St Nazarene Medical Clinic Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by January 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to St Nazarene Medical Clinic Inc, which bills Medicare for the services this clinician delivers.
Clinician (1)
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 05D0963400
St Nazarene Medical Clinic Inc Site 2 · Oxnard, CAFrequently 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 St Nazarene Medical Clinic Inc's NPI number?
The NPI number for St Nazarene Medical Clinic Inc is 1275714917. It was assigned to this organization in the NPPES registry on November 23, 2007.
Where is St Nazarene Medical Clinic Inc located?
St Nazarene Medical Clinic Inc is located at 1100 N Ventura Rd Suite 109, Oxnard, CA 93030. The listed phone number is (805) 983-0547.
What is St Nazarene Medical Clinic Inc's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is St Nazarene Medical Clinic Inc enrolled in Medicare?
Yes. St Nazarene Medical Clinic Inc is registered in the Medicare PECOS enrollment system.
When is St Nazarene Medical Clinic Inc's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (California, Clinic/Group Practice) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through St Nazarene Medical Clinic Inc?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to St Nazarene Medical Clinic Inc. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does St Nazarene Medical Clinic Inc hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 05D0963400) is associated with this NPI, valid through July 27, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for St Nazarene Medical Clinic Inc was last updated on January 14, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years 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.
# St Nazarene Medical Clinic Inc · NPI 1275714917
Primary Care organization in Oxnard, California. Organization record, active in the CMS NPPES registry since November 23, 2007.
## Identity
- **NPI:** 1275714917 (Entity type: Organization)
- **Enumerated:** November 23, 2007
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Suzanne Fussell, PRESIDENT
## Practice location
- **Address:** 1100 N VENTURA RD, SUITE 109, Oxnard, CA 93030-3841
- **Phone:** (805) 983-0547 · **Fax:** (805) 983-0423
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** January 31, 2027 (Non-DME Part B, California, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1 clinician (Family Practice) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 14, 2011
- **Other identifiers:** Medicare PIN W14637 (CA)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1275714917) · Data from the CMS NPPES public registry.