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SOPER FAMILY PSYCHIATRY MEDICAL GROUP
NPI 1699158634
Clinic/Center - Medical Specialty in Mckinleyville, CA

Active since July 08, 2015
1836 CENTRAL AVE STE A, MCKINLEYVILLE, CA 95519(707) 445-4705(707) 445-0581 Get Directions Write a Review

NPPES record last updated: October 16, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Soper Family Psychiatry Medical Group NPPES

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

SOPER FAMILY PSYCHIATRY MEDICAL GROUP (NPI 1699158634) is a healthcare organization registered as a medical specialty in Mckinleyville, California and active in the NPI registry since July 2015. The organization lists Niki Moore, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1699158634
Entity TypeOrganization
Primary Taxonomy261QM2500X
Legal Business NameSOPER FAMILY PSYCHIATRY MEDICAL GROUP
Location Address1836 CENTRAL AVE STE AMckinleyville, CA 95519-3667
Mailing Address1836 Central Ave Ste AMckinleyville, CA 95519-3667 · (707) 445-4705 · Fax (707) 445-0581
Phone(707) 445-4705
Fax(707) 445-0581
Organization SubpartNo
Authorized OfficialNiki MooreOffice Manager · (707) 445-4705
Enumeration DateJuly 8, 2015
Last NPPES UpdateOctober 16, 2024
NPPES CertifiedOctober 15, 2024
✔ NPI 1699158634 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinic/Center · Medical SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM2500X
License✔ Licensed in CA · G59380
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
Also ListedPsychologistTaxonomy 103T00000X
Also ListedPsychologist · Clinical Child & AdolescentTaxonomy 103TC2200X
1836 CENTRAL AVE STE A, Mckinleyville, CA 95519
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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)

Soper Family Psychiatry Medical Group is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Soper Family Psychiatry Medical Group, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (4)

Wendy Brandon, NP
Nurse Practitioner
NPI 1912004896
1836 CENTRAL AVE STE A
Mckinleyville, CA 95519
(707) 445-4705
✔ PECOS✔ Accepts MedicareSame address
Robert Soper, M.D.
Psychiatry
NPI 1215065362
104 W ST
Eureka, CA 95501
(707) 445-4705
✔ PECOS✔ Accepts Medicare10 mi
Steven Roth, PH.D.
Clinical Psychologist
NPI 1417971946
720 WOOD ST
Eureka, CA 95501
(707) 268-2990
✔ PECOS✔ Accepts Medicare11 mi
Anirudh Rai, MD
Family Practice
NPI 1679136865
23845 MCBEAN PKWY STE 220
Valencia, CA 91355
(818) 730-4953
✔ PECOS✔ Accepts Medicare544 mi

Source: 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 Soper Family Psychiatry Medical Group's NPI number?

The NPI number for Soper Family Psychiatry Medical Group is 1699158634. It was assigned to this organization in the NPPES registry on July 8, 2015.

Where is Soper Family Psychiatry Medical Group located?

Soper Family Psychiatry Medical Group is located at 1836 Central Ave Ste A, Mckinleyville, CA 95519. The listed phone number is (707) 445-4705.

What is Soper Family Psychiatry Medical Group's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Medical Specialty, with taxonomy code 261QM2500X.

Is Soper Family Psychiatry Medical Group enrolled in Medicare?

Yes. Soper Family Psychiatry Medical Group is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Soper Family Psychiatry Medical Group?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians reassign their Medicare billing to Soper Family Psychiatry Medical Group, in Clinical Psychologist, Family Practice, Nurse Practitioner and Psychiatry. 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. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Soper Family Psychiatry Medical Group was last updated on October 16, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.