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PURISIMA FAMILY MEDICINE, INC.
NPI 1881821387
Family Medicine in Half Moon Bay, CA

Active since June 11, 2009CLIA 05D1102498 · Waiver
575 KELLY ST, HALF MOON BAY, CA 94019(650) 288-0508(650) 713-0535 Get Directions Write a Review

NPPES record last updated: June 11, 2009. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Purisima Family Medicine, Inc. NPPES

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

PURISIMA FAMILY MEDICINE, INC. (NPI 1881821387) is a healthcare organization registered as a family medicine in Half Moon Bay, California and active in the NPI registry since June 2009. The organization holds a CLIA Waiver certificate valid through July 19, 2027 and lists Daniel Eugene Mcmillan, President, as its authorized official.

NPPES Registry Identity

NPI1881821387
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NamePURISIMA FAMILY MEDICINE, INC.
Location Address575 KELLY STHalf Moon Bay, CA 94019-1719
Mailing AddressPo Box 277Half Moon Bay, CA 94019-0277 · (650) 288-0508 · Fax (650) 713-0535
Phone(650) 288-0508
Fax(650) 713-0535
Organization SubpartNo
Authorized OfficialDaniel Eugene McmillanPresident · (650) 288-0508
Enumeration DateJune 11, 2009
✔ NPI 1881821387 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.
575 KELLY ST, Half Moon Bay, CA 94019
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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)

Purisima 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 Purisima 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)

Daniel Mcmillan, M.D.
Family Practice
NPI 1588692107
575 KELLY ST
Half Moon Bay, CA 94019
(650) 560-0216
✔ PECOS✔ Accepts MedicareSame address
Jill Pavliscak, M.D.
Family Practice
NPI 1144258765
575 KELLY ST
Half Moon Bay, CA 94019
(650) 560-0216
✔ 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 05D1102498

Purisima Family Medicine Inc · Half Moon Bay, CA
Active · expires Jul 19, 2027
CLIA Number05D1102498
Laboratory TypePhysician Office
Certificate Effective DateJuly 20, 2025
Certificate Expiration DateJuly 19, 2027
Laboratory DirectorDaniel E. Mc Millan, MD
Laboratory Phone(650) 560-0216
Laboratory LocationPurisima Family Medicine Inc575 Kelly St, Half Moon Bay, CA 94019
CLIA data matches this NPI record on: Address Name
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 Purisima Family Medicine, Inc.'s NPI number?

The NPI number for Purisima Family Medicine, Inc. is 1881821387. It was assigned to this organization in the NPPES registry on June 11, 2009.

Where is Purisima Family Medicine, Inc. located?

Purisima Family Medicine, Inc. is located at 575 Kelly St, Half Moon Bay, CA 94019. The listed phone number is (650) 288-0508.

What is Purisima Family Medicine, Inc.'s specialty?

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

Is Purisima Family Medicine, Inc. enrolled in Medicare?

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

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

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Family Practice, reassign their Medicare billing to Purisima 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 Purisima Family Medicine, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D1102498) is associated with this NPI, valid through July 19, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Purisima Family Medicine, Inc. was last updated on June 11, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.