PROVIDENCE MEDICAL FOUNDATION
NPI 1740584473
Internal Medicine in Santa Rosa, CA

Q: What is Providence Medical Foundation's NPI number?

The NPI number for Providence Medical Foundation is 1740584473. It was assigned to this organization in the NPPES registry on January 10, 2011. The provider was formerly known as St Joseph Heritage Healthcare.

Q: What is Providence Medical Foundation's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Active since January 10, 2011

500 DOYLE PARK DR, SUITE 303, SANTA ROSA, CA 95405(707) 303-8300(707) 303-8301 Get Directions Write a Review

NPPES record last updated: December 3, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 3, 2025, May 5, 2021, Sep 11, 2017 (3 updates tracked since 2017).

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About Providence Medical Foundation NPPES

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

PROVIDENCE MEDICAL FOUNDATION (NPI 1740584473), doing business as St Joseph Heritage Healthcare, is a healthcare organization registered as an internal medicine in Santa Rosa, California and active in the NPI registry since January 2011. The organization maintains a secondary practice location in Santa Rosa and lists Donald W. Anderson, Assistant Secretary Of Enrollments, as its authorized official.

NPPES Registry Identity

NPI1740584473

Entity TypeOrganization

Primary Taxonomy207R00000X

Legal Business NamePROVIDENCE MEDICAL FOUNDATION

Location Address500 DOYLE PARK DR, SUITE 303Santa Rosa, CA 95405-4558

Mailing AddressPo Box 31001 - 1920Pasadena, CA 91110-1920 · (714) 449-4800 · Fax (714) 449-4956

Phone(707) 303-8300

Fax(707) 303-8301

Organization SubpartNo

Authorized OfficialDonald W. AndersonAssistant Secretary Of Enrollments · (425) 358-9786

Enumeration DateJanuary 10, 2011

Last NPPES UpdateDecember 3, 20253 updates tracked since enumeration

NPPES CertifiedDecember 3, 2025

✔ NPI 1740584473 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

Definition

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.

500 DOYLE PARK DR, Santa Rosa, CA 95405

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Other Names 1

Former Legal Business NameSt Joseph Heritage Healthcare

Secondary Practice Location 1

Location 1500 Doyle Park DrSanta Rosa, CA 95405-4558 · Phone (707) 528-1050

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

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LEO ARTHUR SMITH MD

Family Medicine

500 DOYLE PARK DR, SUITE G-04
SANTA ROSA, CA 95405

Sonoma County (707) 303-8360

CYNTHIA R. INGELS MSN,N.P.

Nurse Practitioner (Family)

500 DOYLE PARK DR, SUITE 103
SANTA ROSA, CA 95405

Sonoma County (707) 579-1102

DR. JAMES CHARLES DEVORE MD

Family Medicine

500 DOYLE PARK DR, SUITE G04
SANTA ROSA, CA 95405

Sonoma County (707) 303-8360

DR. TOMAS VASILIAUSKAS M.D.

Internal Medicine (Cardiovascular Disease)

500 DOYLE PARK DR, SUITE G05
SANTA ROSA, CA 95405

Sonoma County (707) 576-7100

ERAN MATALON M.D.

Internal Medicine

500 DOYLE PARK DR, SUITE 304
SANTA ROSA, CA 95405

Sonoma County (707) 545-1700

RAMZI KHALIL DEEIK M.D.

Thoracic Surgery (Cardiothoracic Vascular Surgery)

500 DOYLE PARK DR, SUITE G-05
SANTA ROSA, CA 95405

Sonoma County (707) 255-8825

DR. JOEL E PAINE MD

Internal Medicine

500 DOYLE PARK DR, SUITE 300
SANTA ROSA, CA 95405

Sonoma County (707) 303-8344

ANNADEL MEDICAL GROUP, INC

Pediatrics

500 DOYLE PARK DR, SUITE 100
SANTA ROSA, CA 95405

Sonoma County (707) 544-6090

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 1740584473. It was assigned to this organization in the NPPES registry on January 10, 2011. The provider was formerly known as St Joseph Heritage Healthcare.

Where is Providence Medical Foundation located?

Providence Medical Foundation is located at 500 Doyle Park Dr Suite 303, Santa Rosa, CA 95405. The listed phone number is (707) 303-8300.

What is Providence Medical Foundation's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

When was this NPI record last updated?

The NPPES record for Providence Medical Foundation was last updated on December 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.