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PROVIDENCE MEDICAL FOUNDATION
NPI 1427305960
Family Medicine in Mission Viejo, CA

Active since August 14, 2012CLIA Certified · 4 labs
26522 LA ALAMEDA, SUITE 120, MISSION VIEJO, CA 92691(949) 364-9631 Get Directions Write a Review

NPPES record last updated: December 1, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 1, 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 1427305960), doing business as St Joseph Heritage Healthcare, is a healthcare organization registered as a family medicine in Mission Viejo, California and active in the NPI registry since August 2012. The organization holds 4 active CLIA laboratory certificates and lists Donald W. Anderson, Assistant Secretary Of Enrollments, as its authorized official.

NPPES Registry Identity

NPI1427305960
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NamePROVIDENCE MEDICAL FOUNDATION
Location Address26522 LA ALAMEDA, SUITE 120Mission Viejo, CA 92691-6330
Mailing AddressPo Box 31001 - 1920Pasadena, CA 91110-1920 · (714) 449-4800
Phone(949) 364-9631
Organization SubpartNo
Authorized OfficialDonald W. AndersonAssistant Secretary Of Enrollments · (425) 358-9786
Enumeration DateAugust 14, 2012
Last NPPES UpdateDecember 1, 20253 updates tracked since enumeration
NPPES CertifiedDecember 1, 2025
✔ NPI 1427305960 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedPhysical Medicine & RehabilitationTaxonomy 208100000X
26522 LA ALAMEDA, Mission Viejo, CA 92691
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Other Names 2

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

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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, 202 practice 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
Martha Carranza, NP
Nurse Practitioner
NPI 1376614925
26800 CROWN VALLEY PKWY SUITE 230
Mission Viejo, CA 92691
(949) 542-8004
✔ PECOS0.1 mi
Tina Ortiz
Marriage and Family Therapist
NPI 1063539567
26800 CROWN VALLEY PKWY STE 325
Mission Viejo, CA 92691
(949) 364-6000
✔ PECOS0.1 mi
George Schiffman, M.D.
Pulmonary Disease
NPI 1104803188
26800 CROWN VALLEY PKWY STE 205
Mission Viejo, CA 92691
(949) 364-3330
✔ PECOS✔ Accepts Medicare0.1 mi
Shenoda Abd Elmaseh
Family Practice
NPI 1194348656
26800 CROWN VALLEY PKWY STE 150
Mission Viejo, CA 92691
(949) 276-2111
✔ PECOS✔ Accepts Medicare0.1 mi
Jeremy Chang, MD
Obstetrics/Gynecology
NPI 1679004691
26800 CROWN VALLEY PKWY STE 545
Mission Viejo, CA 92691
(949) 364-1040
✔ PECOS✔ Accepts Medicare0.1 mi
Lisa Dao, MD
Endocrinology
NPI 1114422730
26800 CROWN VALLEY PKWY STE 230
Mission Viejo, CA 92691
(949) 542-8004
✔ PECOS✔ Accepts Medicare0.1 mi
Ihab Alomari, MD
Cardiovascular Disease (Cardiology)
NPI 1669628319
26800 CROWN VALLEY PKWY STE 250
Mission Viejo, CA 92691
(949) 364-3388
✔ PECOS✔ Accepts Medicare0.1 mi
Diane Tran, MD
Advanced Heart Failure and Transplant Cardiology
NPI 1962665786
26800 CROWN VALLEY PKWY STE 250
Mission Viejo, CA 92691
(949) 364-3570
✔ PECOS✔ Accepts Medicare0.1 mi
Jae Choi, MD
Internal Medicine
NPI 1992371884
26800 CROWN VALLEY PKWY STE 305
Mission Viejo, CA 92691
(949) 364-6000
✔ PECOS✔ Accepts Medicare0.1 mi
May Chen, MD
Nephrology
NPI 1881772887
26800 CROWN VALLEY PKWY SUITE 250
Mission Viejo, CA 92691
(949) 364-0644
✔ PECOS✔ Accepts Medicare0.1 mi
Jaya Philipose, M.D.
Rheumatology
NPI 1477671386
26800 CROWN VALLEY PKWY SUITE 330
Mission Viejo, CA 92691
(949) 364-7246
✔ PECOS✔ Accepts Medicare0.1 mi
Christine Coy, MS, RD
Registered Dietitian or Nutrition Professional
NPI 1245218437
26800 CROWN VALLEY PKWY STE 250
Mission Viejo, CA 92691
(949) 542-8004
✔ Accepts Medicare0.1 mi
Peter Czuleger, M.D.
General Practice
NPI 1043265580
26800 CROWN VALLEY PKWY SUITE 150
Mission Viejo, CA 92691
(949) 276-2111
✔ PECOS✔ Accepts Medicare0.1 mi
Aseem Desai, M.D.
Cardiac Electrophysiology
NPI 1609852888
26800 CROWN VALLEY PKWY SUITE 100
Mission Viejo, CA 92691
(949) 364-3570
✔ PECOS✔ Accepts Medicare0.1 mi
Parshaw Dorriz, MD
Neurology
NPI 1972940625
26800 CROWN VALLEY PKWY STE 385
Mission Viejo, CA 92691
(949) 542-8002
✔ PECOS✔ Accepts Medicare0.1 mi
Lisa Hoang, M.D.
Pediatric Medicine
NPI 1750687638
26800 CROWN VALLEY PKWY STE 540
Mission Viejo, CA 92691
(949) 242-6915
✔ PECOS0.1 mi
David Kawanishi, M.D.
Interventional Cardiology
NPI 1518944057
26800 CROWN VALLEY PKWY SUITE 250
Mission Viejo, CA 92691
(949) 364-3570
✔ PECOS✔ Accepts Medicare0.1 mi
Austin Longberg, D.O
Dermatology
NPI 1336503416
26800 CROWN VALLEY PKWY STE 435
Mission Viejo, CA 92691
(949) 542-8007
✔ PECOS✔ Accepts Medicare0.1 mi
Daniel Ponticiello, MD
Critical Care (Intensivists)
NPI 1417185273
26800 CROWN VALLEY PKWY STE 205
Mission Viejo, CA 92691
(949) 364-3330
✔ PECOS✔ Accepts Medicare0.1 mi
Stefanie Zargarbashi, LCSW
Clinical Social Worker
NPI 1629527692
26800 CROWN VALLEY PKWY STE 325
Mission Viejo, CA 92691
(949) 364-6000
✔ PECOS0.1 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 6

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 Compliance 05D2029948

Providence Medical Foundation · Mission Viejo, CA
Active · expires Mar 25, 2028
CLIA Number05D2029948
Laboratory TypePhysician Office
Certificate Effective DateMarch 26, 2026
Certificate Expiration DateMarch 25, 2028
Laboratory DirectorTuyet A. Nguyen
Laboratory Phone(949) 542-8007
Laboratory LocationProvidence Medical Foundation26800 Crown Valley Pkwy, Ste 435, Mission Viejo, CA 92691
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Waiver 05D2296289

Providence Medical Foundation · Mission Viejo, CA
Active · expires Dec 26, 2027
CLIA Number05D2296289
Laboratory TypePhysician Office
Certificate Effective DateDecember 27, 2025
Certificate Expiration DateDecember 26, 2027
Laboratory DirectorRaymond Kwa
Laboratory Phone(949) 365-2444
Laboratory LocationProvidence Medical Foundation26800 Crown Valley Parkway Suite 290, Mission Viejo, CA 92691
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 05D0994423

Providence Medical Foundation · Mission Viejo, CA
Active · expires Nov 9, 2027
CLIA Number05D0994423
Laboratory TypePhysician Office
Certificate Effective DateNovember 10, 2025
Certificate Expiration DateNovember 9, 2027
Laboratory DirectorChad Wadell
Laboratory Phone(949) 364-6000
Laboratory LocationProvidence Medical Foundation26800 Crown Valley Pkwy Suite 315, Mission Viejo, CA 92691
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Compliance 05D0707127

Providence Medical Foundation · Mission Viejo, CA
Active · expires Jan 22, 2027
CLIA Number05D0707127
Laboratory TypePhysician Office
Certificate Effective DateJanuary 23, 2025
Certificate Expiration DateJanuary 22, 2027
Laboratory DirectorMinch K. Fong MD
Laboratory Phone(949) 347-0600
Laboratory LocationProvidence Medical Foundation27799 Medical Center Rd, Ste 460, Mission Viejo, CA 92691
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Waiver 05D0928547

Providence Medical Foundation · Mission Viejo, CA
Expired · Oct 16, 2026
CLIA Number05D0928547
Laboratory TypePhysician Office
Certificate Effective DateOctober 17, 2024
Certificate Expiration DateOctober 16, 2026
Laboratory DirectorEdward J. Block
Laboratory Phone(949) 364-5090
Laboratory LocationProvidence Medical Foundation27871 Medical Center Road, Suite #200, Mission Viejo, CA 92691
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 05D2155712

Providence Medical Foundation · Mission Viejo, CA
Expired · Oct 2, 2026
CLIA Number05D2155712
Laboratory TypeAncillary Testing Site In Health Care Center
Certificate Effective DateOctober 3, 2024
Certificate Expiration DateOctober 2, 2026
Laboratory DirectorArthur H. Loussararian
Laboratory Phone(949) 347-3620
Laboratory LocationProvidence Medical Foundation26800 Crown Valley Pkwy Suite 115, Mission Viejo, CA 92691
CLIA data matches this NPI record on: 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 1427305960. It was assigned to this organization in the NPPES registry on August 14, 2012. 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 26522 La Alameda Suite 120, Mission Viejo, CA 92691. The listed phone number is (949) 364-9631.

What is Providence Medical Foundation's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

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, 202 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Providence Medical Foundation hold CLIA laboratory certificates?

Yes. 4 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Providence Medical Foundation was last updated on December 1, 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.