PROVIDENCE MEDICAL FOUNDATION
NPI 1639715709
Family Medicine in Anaheim, CA
About Providence Medical Foundation NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PROVIDENCE MEDICAL FOUNDATION (NPI 1639715709), doing business as St Joseph Heritage Healthcare, is a healthcare organization registered as a family medicine in Anaheim, California and active in the NPI registry since November 2019. The organization lists Donald W. Anderson, Assistant Secretary Of Enrollments, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Group Practice 1
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
1,692Medicare enrollment records show 1,692 clinicians reassign Medicare billing to Providence Medical Foundation, which bills Medicare for the services they deliver. Of these, 470 practice within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 61
Nearest to this location (20)
See all 1,692Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 1639715709. It was assigned to this organization in the NPPES registry on November 22, 2019. The provider was formerly known as St Joseph Heritage Healthcare.
Where is Providence Medical Foundation located?
Providence Medical Foundation is located at 200 W Center Street Promenade, Anaheim, CA 92805. The listed phone number is (147) 123-5007.
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, 470 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Providence Medical Foundation was last updated on January 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.
# Providence Medical Foundation · NPI 1639715709
Family Medicine organization in Anaheim, California. Organization record, active in the CMS NPPES registry since November 22, 2019.
## Identity
- **NPI:** 1639715709 (Entity type: Organization)
- **Enumerated:** November 22, 2019
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Also known as:** St Joseph Heritage Healthcare (Former Legal Business Name)
- **Organization subpart:** No
- **Authorized official:** Donald Anderson, ASSISTANT SECRETARY OF ENROLLMENTS
## Practice location
- **Address:** 200 W CENTER STREET PROMENADE, Anaheim, CA 92805-3960
- **Phone:** (147) 123-5007
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1,692 clinicians in 61 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (274), Internal Medicine (234), Family Practice (232); 470 practice within 10 miles; [full list](https://npiprofile.com/npi/1639715709/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 6, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1639715709) · Data from the CMS NPPES public registry.