ULTIMATE MEDICAL PRACTICE A PROFESSIONAL CORPORATION
NPI 1962659573
Clinic/Center - Primary Care in Highland, CA
About Ultimate Medical Practice A Professional Corporation NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ULTIMATE MEDICAL PRACTICE A PROFESSIONAL CORPORATION (NPI 1962659573) is a healthcare organization registered as a primary care in Highland, California and active in the NPI registry since August 2008. The organization holds a CLIA Waiver certificate valid through December 17, 2026 and lists Richard Kangah, Medical Director/president, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Ultimate Medical Practice A Professional Corporation is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Ultimate Medical Practice A Professional Corporation, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (2)
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 05D1086304
Ultimate Medical Practice Inc · Highland, CAFrequently 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 Ultimate Medical Practice A Professional Corporation's NPI number?
The NPI number for Ultimate Medical Practice A Professional Corporation is 1962659573. It was assigned to this organization in the NPPES registry on August 26, 2008.
Where is Ultimate Medical Practice A Professional Corporation located?
Ultimate Medical Practice A Professional Corporation is located at 3654 Highland Ave Suite 15, Highland, CA 92346. The listed phone number is (909) 864-1006.
What is Ultimate Medical Practice A Professional Corporation's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Ultimate Medical Practice A Professional Corporation enrolled in Medicare?
Yes. Ultimate Medical Practice A Professional Corporation is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Ultimate Medical Practice A Professional Corporation?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Ultimate Medical Practice A Professional Corporation, in General Practice 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, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Ultimate Medical Practice A Professional Corporation hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 05D1086304) is associated with this NPI, valid through December 17, 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 Ultimate Medical Practice A Professional Corporation was last updated on March 4, 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.
# Ultimate Medical Practice A Professional Corporation · NPI 1962659573
Primary Care organization in Highland, California. Organization record, active in the CMS NPPES registry since August 26, 2008.
## Identity
- **NPI:** 1962659573 (Entity type: Organization)
- **Enumerated:** August 26, 2008
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Richard Kangah, MEDICAL DIRECTOR/PRESIDENT
## Practice location
- **Address:** 3654 HIGHLAND AVE, SUITE 15, Highland, CA 92346-2614
- **Phone:** (909) 864-1006 · **Fax:** (909) 864-1625
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: General Practice (1), Nurse Practitioner (1); 2 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 4, 2009
- **CLIA laboratory certificates:** 1 on file
---
Source: [NPI Profile](https://npiprofile.com/npi/1962659573) · Data from the CMS NPPES public registry.