PROVIDENCE MEDICAL GROUP – Cardiovascular Disease Physician, NPI 1982921490

PROVIDENCE MEDICAL GROUP is a healthcare provider. based in Pasadena, California. specializing in Cardiovascular Disease Physician. The NPI Number for PROVIDENCE MEDICAL GROUP is 1982921490

Main info

Organization
Name
PROVIDENCE MEDICAL GROUP
NPI
1982921490
Phone
Not provided
Address
PO BOX 31001 - 4180
Authorized Official
DONALD WAYNE ANDERSON JR. ASST SEC FOR ENROLLMENT
Enumeration Date
23 April 2010
Last Update Date
4 July 2025
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness90
Years active:16State licenses:0Digital endpoints

Provider Addresses for PROVIDENCE MEDICAL GROUP

  • PO BOX 31001 - 4180

    PASADENA, CA 911104180

    Phone:

    Type: Mailing

  • 1355 EXCHANGE ST

    ASTORIA, OR 971033980

    Phone: (503) 836-4600

    Fax: (503) 836-4613

    Type: Location

  • PO BOX 3158

    PORTLAND, OR 972083158

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

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Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 91110)

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Reviews

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Frequently asked questions

Is PROVIDENCE MEDICAL GROUP listed with a National Provider Identifier?
Yes — PROVIDENCE MEDICAL GROUP has NPI 1982921490 on file in the registry.
Would PROVIDENCE MEDICAL GROUP appear as active to a payer?
You can treat PROVIDENCE MEDICAL GROUP as active for directory purposes; confirm clinical privileges separately.
What area of care is associated with PROVIDENCE MEDICAL GROUP?
PROVIDENCE MEDICAL GROUP's record emphasizes Cardiovascular Disease Physician. Clinical services aligned with this taxonomy classification.
Where in California is PROVIDENCE MEDICAL GROUP registered?
Use Pasadena, California as the headline location for PROVIDENCE MEDICAL GROUP here.
What does 3 location(s) imply?
3 practice locations appear in the available data.

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