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PACIFIC GROVE FAMILY MEDICINE, INC.
NPI 1710232996
Family Medicine in Pacific Grove, CA

Active since July 13, 2012CLIA 05D0975501 · Waiver
621 FOREST AVE, PACIFIC GROVE, CA 93950(831) 649-1011(831) 373-8201 Get Directions Write a Review

NPPES record last updated: July 13, 2012. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Pacific Grove Family Medicine, Inc. NPPES

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

PACIFIC GROVE FAMILY MEDICINE, INC. (NPI 1710232996) is a healthcare organization registered as a family medicine in Pacific Grove, California and active in the NPI registry since July 2012. The organization holds a CLIA Waiver certificate valid through July 9, 2028 and lists Eliot Stuart Light, President, as its authorized official.

NPPES Registry Identity

NPI1710232996
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NamePACIFIC GROVE FAMILY MEDICINE, INC.
Location Address621 FOREST AVEPacific Grove, CA 93950-4264
Mailing Address621 Forest AvePacific Grove, CA 93950-4264 · (831) 649-1011 · Fax (831) 373-8201
Phone(831) 649-1011
Fax(831) 373-8201
Organization SubpartNo
Authorized OfficialEliot Stuart LightPresident · (831) 649-1011
Enumeration DateJuly 13, 2012
✔ NPI 1710232996 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ 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.
621 FOREST AVE, Pacific Grove, CA 93950
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE 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)

Pacific Grove Family Medicine, Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Pacific Grove Family Medicine, Inc., which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Eliot Light, MD
Family Practice
NPI 1942382577
621 FOREST AVE
Pacific Grove, CA 93950
(831) 649-1011
✔ PECOS✔ Accepts MedicareSame address
Siang Lo, DO
Family Practice
NPI 1821146606
621 FOREST AVE
Pacific Grove, CA 93950
(831) 649-1011
✔ PECOS✔ Accepts MedicareSame address

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 05D0975501

Pacific Grove Family Medicine Inc · Pacific Grove, CA
Active · expires Jul 9, 2028
CLIA Number05D0975501
Laboratory TypePhysician Office
Certificate Effective DateJuly 10, 2026
Certificate Expiration DateJuly 9, 2028
Laboratory DirectorEliot S. Light MD
Laboratory Phone(831) 649-1011
Laboratory LocationPacific Grove Family Medicine Inc621 Forest Ave, Pacific Grove, CA 93950
CLIA data matches this NPI record on: Address Name Phone
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 Pacific Grove Family Medicine, Inc.'s NPI number?

The NPI number for Pacific Grove Family Medicine, Inc. is 1710232996. It was assigned to this organization in the NPPES registry on July 13, 2012.

Where is Pacific Grove Family Medicine, Inc. located?

Pacific Grove Family Medicine, Inc. is located at 621 Forest Ave, Pacific Grove, CA 93950. The listed phone number is (831) 649-1011.

What is Pacific Grove Family Medicine, Inc.'s specialty?

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

Is Pacific Grove Family Medicine, Inc. enrolled in Medicare?

Yes. Pacific Grove Family Medicine, Inc. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Pacific Grove Family Medicine, Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Family Practice, reassign their Medicare billing to Pacific Grove Family Medicine, 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. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Pacific Grove Family Medicine, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D0975501) is associated with this NPI, valid through July 9, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Pacific Grove Family Medicine, Inc. was last updated on July 13, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.