EVERGREEN URGENT CARE INC
NPI 1487048963
Clinic/Center - Urgent Care in San Jose, CA
NPI Status: Active since March 24, 2015
Contact Information
2365 QUIMBY ROAD
SUITE 160
SAN JOSE, CA
ZIP 95122
Phone: (408) 258-5083
Fax: (408) 258-4347
- Organization
- Clinic/Center
- Urgent Care
- Medicare Supplier
- Accepts Medicare Approved Payment
- CLIA Number: 05D2100866
- CLIA Cert. Type: Other - URGENT CARE CENTER
- CLIA Exp. Date: 05-20-2026
About EVERGREEN URGENT CARE INC
This page provides the complete NPI Profile along with additional information for Evergreen Urgent Care Inc, a provider established in San Jose, California operating as a Clinic/center, focusing in urgent care . The healthcare provider is registered in the NPI registry with number 1487048963 assigned on March 2015. The practitioner's primary taxonomy code is 261QU0200X. The provider is registered as an organization and their NPI record was last updated 10 years ago. The authorized official of this NPI record is Mr. Tam Hoang Ngnyen D.o. (Ceo/physician)
- NPI
- 1487048963
- Provider Name
- EVERGREEN URGENT CARE INC
- Entity Type
- Organization
- Location Address
- 2365 QUIMBY ROAD SUITE 160 SAN JOSE, CA 95122
- Location Phone
- (408) 258-5083
- Location Fax
- (408) 258-4347
- Mailing Address
- 2110 MCKEE RD SAN JOSE, CA 95116
- Mailing Phone
- (408) 258-5083
- Mailing Fax
- (408) 258-4347
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 03-24-2015
- Last Update Date
- 10-22-2015
- Code Navigator
Evergreen Urgent Care Inc is a medicare supplier with PTAN 20560415 who accepts Medicare assignment for all durable medical equipment and supplies. The provider accepts the Medicare allowable as payment in full.The supplier carries the following product categories: Epoetin or Immunosuppressive Drugs or Infusion Drugs or Nebulizer Drugs or Oral Anticancer Drugs or Oral Antiemetic Drugs.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Urgent Care
- Taxonomy Code
- 261QU0200X
- Type
- Ambulatory Health Care Facilities
Medical Equipment Supplier
The provider carries the following medical supplies product categories:
- PTAN
- 20560415
- Accepts Medicare Assignment
- YES
- Specialities List
- Pharmacy.
- Competitive Bidding
- NO
Supplies List
- Epoetin - Epoetin is a man-made version of human erythropoietin (EPO)
- Immunosuppressive Drugs - Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
- Infusion Drugs -
- Nebulizer Drugs - Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
- Oral Anticancer Drugs - FDA anticancer drugs
- Oral Antiemetic Drugs - FDA antiemetic drugs
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 05D2100866
- Facility Type
- Other - URGENT CARE CENTER
- Certificate Effective Date
- May 21, 2024
- Certificate Expiration Date
- May 20, 2026
- Laboratory Director
- TAM H. NGUYEN
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Evergreen Urgent Care Inc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 4 | 8 | 7 | 0 | 4 | 8 | 9 | 6 | 3 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 4 | 16 | 7 | 0 | 4 | 16 | 9 | 12 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 4 + 1 + 6 + 7 + 0 + 4 + 1 + 6 + 9 + 1 + 2 + 24 = 67 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 67 = 3 | 3 | ||||||||
The NPI number 1487048963 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following provider is registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1215445291 | VALLEY ADVANTAGE MEDICAL GROUP INC Organization | Internal Medicine | 2365 QUIMBY ROAD SUITE 160 SAN JOSE, CA 95122 (408) 550-2750 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1487048963, enumerated in the NPI registry as an "organization" on March 24, 2015
The provider is located at 2365 Quimby Road Suite 160 San Jose, Ca 95122 and the phone number is (408) 258-5083
This medical organization specializes in Clinic/Center with taxonomy code 261QU0200X with a focus in Urgent Care
The provider's CLIA number is 05D2100866 for a "other - urgent care center" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on March 24, 2015. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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