PREVENTIVE MEDICAL CENTER OF MARIN INC
NPI 1912067828
Clinic/Center - Primary Care in San Rafael, CA
About Preventive Medical Center Of Marin Inc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PREVENTIVE MEDICAL CENTER OF MARIN INC (NPI 1912067828) is a healthcare organization registered as a primary care in San Rafael, California and active in the NPI registry since December 2006. The organization lists Elson M Haas, Owner Medical Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Preventive Medical Center Of Marin Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
4Medicare enrollment records show 4 clinicians reassign Medicare billing to Preventive Medical Center Of Marin Inc, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 3 within 10 miles. They are listed nearest first.
Clinicians, nearest first (4)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Preventive Medical Center Of Marin Inc's NPI number?
The NPI number for Preventive Medical Center Of Marin Inc is 1912067828. It was assigned to this organization in the NPPES registry on December 11, 2006.
Where is Preventive Medical Center Of Marin Inc located?
Preventive Medical Center Of Marin Inc is located at 4340 Redwood Hwy Ste Aa, San Rafael, CA 94903. The listed phone number is (415) 472-2343.
What is Preventive Medical Center Of Marin Inc's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Preventive Medical Center Of Marin Inc enrolled in Medicare?
Yes. Preventive Medical Center Of Marin Inc is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Preventive Medical Center Of Marin Inc?
According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians reassign their Medicare billing to Preventive Medical Center Of Marin Inc, in General Practice, Internal Medicine and Nurse Practitioner. 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, 1 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Preventive Medical Center Of Marin Inc was last updated on September 29, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Preventive Medical Center Of Marin Inc · NPI 1912067828
Primary Care organization in San Rafael, California. Organization record, active in the CMS NPPES registry since December 11, 2006.
## Identity
- **NPI:** 1912067828 (Entity type: Organization)
- **Enumerated:** December 11, 2006
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Elson Haas, OWNER MEDICAL DIRECTOR
## Practice location
- **Address:** 4340 REDWOOD HWY STE AA, San Rafael, CA 94903-2121
- **Phone:** (415) 472-2343 · **Fax:** (415) 472-7636
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 4 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (2), General Practice (1), Internal Medicine (1); 1 practice at this address and 3 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 29, 2023
- **Other identifiers:** Other 222384942
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Source: [NPI Profile](https://npiprofile.com/npi/1912067828) · Data from the CMS NPPES public registry.