PROVIDENCE MEDICAL FOUNDATION
NPI 1740584473
Internal Medicine in Santa Rosa, CA
NPI Status: Active since January 10, 2011
Contact Information
500 DOYLE PARK DR
SUITE 303
SANTA ROSA, CA
ZIP 95405
Phone: (707) 303-8300
Fax: (707) 303-8301
- Organization
- Internal Medicine
- CLIA Number: 05D2229898
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 04-17-2026
About PROVIDENCE MEDICAL FOUNDATION
This page provides the complete NPI Profile along with additional information for Providence Medical Foundation, an internist established in Santa Rosa, California operating as a Internal Medicine. The healthcare provider is registered in the NPI registry with number 1740584473 assigned on January 2011. The practitioner's primary taxonomy code is 207R00000X. The provider is registered as an organization and their NPI record was last updated one year ago. Providence Medical Foundation operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's
- NPI
- 1740584473
- Provider Legal Name
- PROVIDENCE MEDICAL FOUNDATION
- Other Organization Name
- Other Name Type
- (6)
- Entity Type
- Organization
- Location Address
- 500 DOYLE PARK DR SUITE 303 SANTA ROSA, CA 95405
- Location Phone
- (707) 303-8300
- Location Fax
- (707) 303-8301
- Mailing Address
- PO BOX 31001 - 1920 PASADENA, CA 91110
- Mailing Phone
- (714) 449-4800
- Mailing Fax
- (707) 303-8301
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 01-10-2011
- Last Update Date
- 12-03-2025
- Code Navigator
An internist like Providence Medical Foundation is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Location Map
Secondary Locations
- 500 Doyle Park Dr
Santa Rosa, CA 95405
(707) 528-1050 - 500 Doyle Park Dr
Santa Rosa, CA 95405
(707) 528-1050
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
Internal Medicine
- Taxonomy Code
- 207R00000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
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
- 05D2229898
- Facility Type
- Physician Office
- Certificate Effective Date
- April 18, 2024
- Certificate Expiration Date
- April 17, 2026
- Laboratory Director
- TOMAS VASILIAUSKAS
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Providence Medical Foundation 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 1740584473, 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 20 providers are registered at the same or a nearby location.
SANTA ROSA, CA 95405
SANTA ROSA, CA 95405
SANTA ROSA, CA 95405
SANTA ROSA, CA 95405
SANTA ROSA, CA 95405
SANTA ROSA, CA 95405
SANTA ROSA, CA 95405
SANTA ROSA, CA 95405
SANTA ROSA, CA 95405
SANTA ROSA, CA 95405
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1740584473, enumerated as an "organization" on January 10, 2011.
The provider is located at 500 DOYLE PARK DR SUITE 303 SANTA ROSA, CA 95405 and the phone number is (707) 303-8300.
Internal Medicine with taxonomy code 207R00000X.
