EVERGREEN URGENT CARE INC
NPI 1487048963
Clinic/Center - Urgent Care in San Jose, CA
NPI Status: Active since March 24, 2015
Contact Information
2365 QUIMBY ROAD
SUITE 160
SAN JOSE, CA
ZIP 95122
Phone: (408) 258-5083
Fax: (408) 258-4347
- Organization
- Clinic/Center
- Urgent Care
- Medicare Supplier
- Accepts Medicare Approved Payment
- CLIA Number: 05D2100866
- CLIA Cert. Type: Other - URGENT CARE CENTER
- CLIA Exp. Date: 05-20-2028
About EVERGREEN URGENT CARE INC
This page provides the complete NPI Profile along with additional information for Evergreen Urgent Care Inc, a provider established in San Jose, California operating as a Clinic/center, focusing in urgent care . The healthcare provider is registered in the NPI registry with number 1487048963 assigned on March 2015. The practitioner's primary taxonomy code is 261QU0200X. The provider is registered as an organization and their NPI record was last updated 11 years ago. The authorized official of this NPI record is Mr. Tam Hoang Ngnyen D.o. (Ceo/physician)
- NPI
- 1487048963
- Provider Name
- EVERGREEN URGENT CARE INC
- Entity Type
- Organization
- Location Address
- 2365 QUIMBY ROAD SUITE 160 SAN JOSE, CA 95122
- Location Phone
- (408) 258-5083
- Location Fax
- (408) 258-4347
- Mailing Address
- 2110 MCKEE RD SAN JOSE, CA 95116
- Mailing Phone
- (408) 258-5083
- Mailing Fax
- (408) 258-4347
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 03-24-2015
- Last Update Date
- 10-22-2015
- Code Navigator
Evergreen Urgent Care Inc is a medicare supplier with PTAN 20560415 who accepts Medicare assignment for all durable medical equipment and supplies. The provider accepts the Medicare allowable as payment in full.The supplier carries the following product categories: Epoetin or Immunosuppressive Drugs or Infusion Drugs or Nebulizer Drugs or Oral Anticancer Drugs or Oral Antiemetic Drugs.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Urgent Care
- Taxonomy Code
- 261QU0200X
- Type
- Ambulatory Health Care Facilities
Medical Equipment Supplier
The provider carries the following medical supplies product categories:
- PTAN
- 20560415
- Accepts Medicare Assignment
- YES
- Specialities List
- Pharmacy.
- Competitive Bidding
- NO
Supplies List
- Epoetin - Epoetin is a man-made version of human erythropoietin (EPO)
- Immunosuppressive Drugs - Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
- Infusion Drugs -
- Nebulizer Drugs - Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
- Oral Anticancer Drugs - FDA anticancer drugs
- Oral Antiemetic Drugs - FDA antiemetic drugs
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 05D2100866
- Facility Type
- Other - URGENT CARE CENTER
- Certificate Effective Date
- May 21, 2026
- Certificate Expiration Date
- May 20, 2028
- Laboratory Director
- TAM H. NGUYEN
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Evergreen Urgent Care Inc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1487048963, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 67. The final step is to find the difference between that total and the next multiple of ten (70 - 67 = 3).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 67 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1487048963, enumerated as an "organization" on March 24, 2015.
The provider is located at 2365 QUIMBY ROAD SUITE 160 SAN JOSE, CA 95122 and the phone number is (408) 258-5083.
Clinic/Center with taxonomy code 261QU0200X and a focus in Urgent Care.
