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DOMINICAN HOSPITAL
NPI 1780692673
Radiology - Diagnostic Radiology in Santa Cruz, CA

Active since August 04, 2006CLIA 05D2313218 · Waiver
1555 SOQUEL DRIVE, SANTA CRUZ, CA 95065(831) 476-1542(831) 464-8977 Get Directions Write a Review

NPPES record last updated: March 27, 2008. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dominican Hospital NPPES

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

DOMINICAN HOSPITAL (NPI 1780692673) is a healthcare organization registered as a diagnostic radiology in Santa Cruz, California and active in the NPI registry since August 2006. The organization holds a CLIA Waiver certificate valid through October 27, 2026 and lists Kenneth E Averill, President, as its authorized official.

NPPES Registry Identity

NPI1780692673
Entity TypeOrganization
Primary Taxonomy2085R0202X
Legal Business NameRADIOLOGY MEDICAL GROUP OF SANTA CRUZ COUNTY INC
Location Address1555 SOQUEL DRIVESanta Cruz, CA 95065-1705
Mailing Address1661 Soquel Drive, Building GSanta Cruz, CA 95065-1709 · (831) 476-1542 · Fax (831) 464-8977
Phone(831) 476-1542
Fax(831) 464-8977
Organization SubpartNo
Authorized OfficialKenneth E AverillPresident · (831) 476-1542
Enumeration DateAugust 4, 2006
Last NPPES UpdateMarch 27, 2008
✔ NPI 1780692673 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0202X
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
1555 SOQUEL DRIVE, Santa Cruz, CA 95065
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Other Names 1

Other NameDominican Hospital

Other Identifiers 3

MedicaidZZZ73807ZCA
Medicare PINCN8304
Medicare PINZZZ73807Z

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

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 05D2313218

Dominican Hospital Lifestyle Mgmt And Community Wellness · Santa Cruz, CA
Active · expires Oct 27, 2026
CLIA Number05D2313218
Laboratory TypeCommunity Clinic
Certificate Effective DateOctober 28, 2024
Certificate Expiration DateOctober 27, 2026
Laboratory DirectorMichael Wickham
Laboratory Phone(831) 457-7077
Laboratory LocationDominican Hospital Lifestyle Mgmt And Community Wellness1555 Soquel Drive, Santa Cruz, CA 95065
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 6

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

PAIN CLINIC OF MONTEREY BAY
Anesthesiology (Pain Medicine)
1555 SOQUEL DRIVE
SANTA CRUZ, CA 95065
Santa Cruz County (831) 462-7700
DR. MICHAEL WAHLERS M.D.
Anesthesiology
1555 SOQUEL DRIVE
SANTA CRUZ, CA 95065
Santa Cruz County (831) 462-7700
STANISLAVA MATEJIN MD
Family Medicine
1555 SOQUEL DRIVE
SANTA CRUZ, CA 95065
Santa Cruz County (831) 462-7296
DR. KATHERINE A KINGHORN MD
Anesthesiology
1555 SOQUEL DRIVE, HOSPITAL BASED AT DOMINICAN HOSPITAL
SANTA CRUZ, CA 95065
Santa Cruz County (831) 462-7630
MR. GLENN BRIAN ROBBINS R.PH.
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
1555 SOQUEL DRIVE
SANTA CRUZ, CA 95065
Santa Cruz County (831) 462-7808
DR. JENIFER I BUTLER M.D.
Hospitalist
1555 SOQUEL DRIVE
SANTA CRUZ, CA 95065
Santa Cruz County (831) 475-1111

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 Radiology Medical Group Of Santa Cruz County Inc's NPI number?

The NPI number for Radiology Medical Group Of Santa Cruz County Inc is 1780692673. It was assigned to this organization in the NPPES registry on August 4, 2006. The provider is also known as Dominican Hospital.

Where is Radiology Medical Group Of Santa Cruz County Inc located?

Radiology Medical Group Of Santa Cruz County Inc is located at 1555 Soquel Drive, Santa Cruz, CA 95065. The listed phone number is (831) 476-1542.

What is Radiology Medical Group Of Santa Cruz County Inc's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Does Radiology Medical Group Of Santa Cruz County Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2313218) is associated with this NPI, valid through October 27, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Radiology Medical Group Of Santa Cruz County Inc was last updated on March 27, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.