ADVENTIST HEALTH CALIFORNIA MEDICAL GROUP, INC. — NPI 1427209097 (Board-Certified Neurologist (Brain, Spine, Stroke & Nerve Specialist) in CLEARLAKE, CA)

CMS-1500 Box 24J / 33a • NPI

1427209097

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

2084N0400X (CMS 13)

Board-Certified Neurologist (Brain, Spine, Stroke & Nerve Specialist)

Box 32 Service Location & ZIP+4

15230 LAKESHORE DR, CLEARLAKE, CA, 95422-8107

✓ 9-Digit EDI 837 ZIP+4 (95422-8107)

Practice Phone & Referral Fax

(707) 995-4500

Fax: (707) 994-2401

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1427209097 (ADVENTIST HEALTH CALIFORNIA MEDICAL GROUP, INC.) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1427209097` (NPI-2 Organization / Facility)
Provider / Legal Name	ADVENTIST HEALTH CALIFORNIA MEDICAL GROUP, INC.
Plain-English Specialty	Board-Certified Neurologist (Brain, Spine, Stroke & Nerve Specialist) NUCC Code: `2084N0400X` (Psychiatry & Neurology, Neurology)
Certifying / Licensing Body	American Board of Psychiatry and Neurology (ABPN)
Practice Location Address	15230 LAKESHORE DR, CLEARLAKE, CA, 95422-8107
Practice Telephone / Fax	Tel: (707) 995-4500 \| Fax: (707) 994-2401
Administrative Mailing Address	10 WOODLAND RD, SAINT HELENA, CA, 94574-9554
Enumeration & Last Sync	Enumerated: 2008-10-01 \| CMS Record Updated: 2008-10-01
Authorized Official	KAYE DONNELLY (Coordinator)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

15230 LAKESHORE DR, CLEARLAKE, CA, 95422-8107

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Plain-English Taxonomy & CMS Crosswalk (2084N0400X)

What Does Taxonomy Code 2084N0400X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 2084N0400X translates to:
"Board-Certified Neurologist (Brain, Spine, Stroke & Nerve Specialist)"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 13 (Physician/Neurology) • CMS Code 86 (Physician/Neuropsychiatry)
Certifying / Accrediting Authority: American Board of Psychiatry and Neurology (ABPN)
Clinical Scope: Stroke recovery, chronic or severe migraines, seizures, numbness/tingling in hands or feet (neuropathy), tremors, memory loss, or suspected CSF leak.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (ADVENTIST HEALTH CALIFORNIA MEDICAL GROUP, INC.)

Typical CPT / Diagnostic Procedures:

Electroencephalography (EEG — CPT 95816) for Seizure & Epilepsy Evaluation
Electromyography (EMG) & Nerve Conduction Studies (NCS)
Lumbar Puncture & Cerebrospinal Fluid (CSF) Pressure/Analysis
Acute Ischemic Stroke NIHSS Assessment & Neuroimaging Review

Common Therapeutic Classes:

CGRP Antagonists & Triptans (Sumatriptan, Rizatriptan) for Migraine
Antiepileptic Drugs (Levetiracetam, Lamotrigine, Valproate)
Levodopa/Carbidopa (Parkinson's Disease) & Gabapentin/Pregabalin (Neuropathy)
Antiplatelet & Secondary Stroke Prevention Regimens

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`2084N0400X` — Psychiatry & Neurology, Neurology Plain English: Board-Certified Neurologist (Brain, Spine, Stroke & Nerve Specialist)	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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ADVENTIST HEALTH CALIFORNIA MEDICAL GROUP, INC. (NPI #1427209097)