STANISLAUS CARDIOLOGY GROUP
NPI 1902828841
Specialist in Modesto, CA
NPI Status: Active since July 23, 2006
Contact Information
3621 FOREST GLENN DR
MODESTO, CA
ZIP 95355
Phone: (209) 521-9661
Fax: (209) 521-9307
- Organization
- Specialist
- CLIA Number: 05D0712866
- CLIA Cert. Type: Other - SURGICAL HOSPITAL
- CLIA Exp. Date: 07-11-2025
About STANISLAUS CARDIOLOGY GROUP
This page provides the complete NPI Profile along with additional information for Stanislaus Cardiology Group, a provider established in Modesto, California operating as a Specialist. The healthcare provider is registered in the NPI registry with number 1902828841 assigned on July 2006. The practitioner's primary taxonomy code is 174400000X with license number FNP 30072 (CA). The provider is registered as an organization and their NPI record was last updated 9 years ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Mr. Kent Hon-wah Wong M.d. (Partner)
- NPI
- 1902828841
- Provider Name
- STANISLAUS CARDIOLOGY GROUP
- Entity Type
- Organization
- Location Address
- 3621 FOREST GLENN DR MODESTO, CA 95355
- Location Phone
- (209) 521-9661
- Location Fax
- (209) 521-9307
- Mailing Address
- 3621 FOREST GLENN DR MODESTO, CA 95355
- Mailing Phone
- (209) 521-9661
- Mailing Fax
- (209) 521-9307
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 07-23-2006
- Last Update Date
- 04-20-2016
- Code Navigator
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
Specialist
- Taxonomy Code
- 174400000X
- Type
- Other Service Providers
- License No.
- FNP 30072
- License State
- CA
- Taxonomy Description
- An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1902828841 | MEDICAID (05) | CA | |
| ZZZ23413Z | MEDICARE PIN (08) | CA |
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
- 05D0712866
- Facility Type
- Other - SURGICAL HOSPITAL
- Certificate Effective Date
- July 12, 2023
- Certificate Expiration Date
- July 11, 2025
- Laboratory Director
- DR. SEPIDEH MAFTOUN-BANANKHAH
- Certificate Type
- Certificate of Accreditation
- Certificate Type Description
- This is a CLIA certificate is issued to Stanislaus Cardiology Group on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.
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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 | 9 | 0 | 2 | 8 | 2 | 8 | 8 | 4 | 1 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 9 | 0 | 2 | 16 | 2 | 16 | 8 | 8 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 9 + 0 + 2 + 1 + 6 + 2 + 1 + 6 + 8 + 8 + 24 = 69 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 69 = 1 | 1 | ||||||||
The NPI number 1902828841 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 6 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1114040029 | MS. MIMSIE M FARRAR N.P. Individual | Nurse Practitioner (Family) | 3621 FOREST GLENN DR MODESTO, CA 95355 (209) 521-7411 |
| 1801898044 | DR. JOYDEV ACHARYA MD Individual | Specialist | 3621 FOREST GLENN DR MODESTO, CA 95355 (209) 521-9661 |
| 1962485938 | MR. HASSAN MOHAMED HUSSAIN MD Individual | Internal Medicine (Cardiovascular Disease) | 3621 FOREST GLENN DR MODESTO, CA 95355 (209) 521-9661 |
| 1386628212 | MR. KENT HON-WAH WONG MD Individual | Internal Medicine (Cardiovascular Disease) | 3621 FOREST GLENN DR MODESTO, CA 95355 (209) 521-9661 |
| 1225011299 | MR. RAJESH KUMAR DUBEY M.D. Individual | Internal Medicine (Cardiovascular Disease) | 3621 FOREST GLENN DR MODESTO, CA 95355 (209) 521-9661 |
| 1255996096 | MADALYNN JOY BAKER Individual | Nurse Practitioner | 3621 FOREST GLENN DR MODESTO, CA 95355 (209) 521-7411 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1902828841, enumerated in the NPI registry as an "organization" on July 23, 2006
The provider is located at 3621 Forest Glenn Dr Modesto, Ca 95355 and the phone number is (209) 521-9661
This medical organization specializes in Specialist with taxonomy code 174400000X
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 05D0712866 for a "other - surgical hospital" facility with a CLIA Certificate of Accreditation. This is a CLIA certificate is issued on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing..
This NPI record was last updated on July 23, 2006. 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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