DOMINICAN PEDIATRIC CLINIC
NPI 1770794265
Clinic/Center in Santa Cruz, CA

NPI Status: Active since May 25, 2007

Contact Information

610 FREDERICK ST
3RD FLOOR
SANTA CRUZ, CA
ZIP 95062
Phone: (831) 462-7501
Fax: (831) 462-7555

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  • Organization
  • Clinic/Center
  • CLIA Number: 05D2281529
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 05-08-2027

About DOMINICAN PEDIATRIC CLINIC

This page provides the complete NPI Profile along with additional information for Dominican Pediatric Clinic, a provider established in Santa Cruz, California operating as a Clinic/center. The healthcare provider is registered in the NPI registry with number 1770794265 assigned on May 2007. The practitioner's primary taxonomy code is 261Q00000X with license number 070000030 (CA). The provider is registered as an organization and their NPI record was last updated 14 years ago. The provider's is doing business as Dominican Pediatric Clinic. The authorized official of this NPI record is Michael Walsh (Chief Financial Officer)

NPI
1770794265
Provider Legal Name
DIGNITY HEALTH
Other Organization Name
DOMINICAN PEDIATRIC CLINIC
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
610 FREDERICK ST 3RD FLOOR SANTA CRUZ, CA 95062
Location Phone
(831) 462-7501
Location Fax
(831) 462-7555
Mailing Address
1555 SOQUEL DR ATTN HOSPITAL PRESIDENT SANTA CRUZ, CA 95065
Mailing Phone
(831) 462-7501
Mailing Fax
(831) 462-7555
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
05-25-2007
Last Update Date
03-27-2012
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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

Clinic/Center

Taxonomy Code
261Q00000X
Type
Ambulatory Health Care Facilities
License No.
070000030
License State
CA
Taxonomy Description
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MICHAEL WALSH

Authorized Official Title
CHIEF FINANCIAL OFFICER
Authorized Official Phone
(831) 462-7504

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
HSP40242GMEDICAID (05)CA 

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
05D2281529
Facility Type
Physician Office
Certificate Effective Date
May 09, 2025
Certificate Expiration Date
May 08, 2027
Laboratory Director
MICHAEL J. ELLISON
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Dominican Pediatric Clinic 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 1770794265, we treat the final digit (5) 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 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 5).

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.

Pos 1
1
Doubled → 2
Pos 2
7
Unchanged
Pos 3
7
Doubled → 14 → 1 + 4
Pos 4
0
Unchanged
Pos 5
7
Doubled → 14 → 1 + 4
Pos 6
9
Unchanged
Pos 7
4
Doubled → 8
Pos 8
2
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
5
Target digit
Regular digit Doubled digit Check digit

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.

1 → 2 7 → 14 → 5 7 → 14 → 5 4 → 8 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 7 + 1 + 4 + 0 + 1 + 4 + 9 + 8 + 2 + 1 + 2 + 24 = 65

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 65 is 70. The difference is the calculated check digit.

70 - 65 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1770794265.

Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Physician Assistant (Medical)
610 FREDERICK ST
SANTA CRUZ, CA 95062

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1770794265, enumerated as an "organization" on May 25, 2007.

The provider is located at 610 FREDERICK ST 3RD FLOOR SANTA CRUZ, CA 95062 and the phone number is (831) 462-7501.

Clinic/Center with taxonomy code 261Q00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.