SAND CANYON MEDICAL GROUP
NPI 1962688390
Clinic/Center - Urgent Care in Irvine, CA
About Sand Canyon Medical Group NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SAND CANYON MEDICAL GROUP (NPI 1962688390) is a healthcare organization registered as an urgent care in Irvine, California and active in the NPI registry since January 2008. The organization holds a CLIA Waiver certificate valid through December 21, 2026 and lists Matthew Mullarky, President, 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)
Sand Canyon Medical Group is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
8Medicare enrollment records show 8 clinicians reassign Medicare billing to Sand Canyon Medical Group, which bills Medicare for the services they deliver. Of these, 5 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (8)
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 05D0981347
Sand Canyon Medical Group · Irvine, 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 Sand Canyon Medical Group's NPI number?
The NPI number for Sand Canyon Medical Group is 1962688390. It was assigned to this organization in the NPPES registry on January 16, 2008.
Where is Sand Canyon Medical Group located?
Sand Canyon Medical Group is located at 16100 Sand Canyon Ave Suite 150, Irvine, CA 92618. The listed phone number is (949) 417-0272.
What is Sand Canyon Medical Group's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Urgent Care, with taxonomy code 261QU0200X.
Is Sand Canyon Medical Group enrolled in Medicare?
Yes. Sand Canyon Medical Group is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Sand Canyon Medical Group?
According to the CMS Revalidation Reassignment List (October 2026 release), 8 clinicians in 3 Medicare specialties reassign their Medicare billing to Sand Canyon Medical Group. 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. The largest specialties are Emergency Medicine (4), Family Practice (3) and Preventive Medicine (1). Of these, 5 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Sand Canyon Medical Group hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 05D0981347) is associated with this NPI, valid through December 21, 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 Sand Canyon Medical Group was last updated on August 13, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.
# Sand Canyon Medical Group · NPI 1962688390
Urgent Care organization in Irvine, California. Organization record, active in the CMS NPPES registry since January 16, 2008.
## Identity
- **NPI:** 1962688390 (Entity type: Organization)
- **Enumerated:** January 16, 2008
- **Primary specialty:** Clinic/Center - Urgent Care · taxonomy 261QU0200X
- **Organization subpart:** No
- **Authorized official:** Matthew Mullarky, PRESIDENT
## Practice location
- **Address:** 16100 SAND CANYON AVE, SUITE 150, Irvine, CA 92618-3716
- **Phone:** (949) 417-0272
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 8 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Emergency Medicine (4), Family Practice (3), Preventive Medicine (1); 5 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 13, 2008
- **Other identifiers:** Medicare PIN W22621 (CA)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1962688390) · Data from the CMS NPPES public registry.