CMS-1500 Box 24J / 33a • NPI
1558873786
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
367500000X (CMS 43)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered
Box 32 Service Location & ZIP+4
444 BRUCE ST, YREKA, CA, 96097-3450
✓ 9-Digit EDI 837 ZIP+4 (96097-3450)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1558873786 (SAMUEL C BIRKHOLZ) 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
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1558873786 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | SAMUEL C BIRKHOLZ |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered NUCC Code: 367500000X (Nurse Anesthetist, Certified Registered) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 444 BRUCE ST, YREKA, CA, 96097-3450 |
| Practice Telephone / Fax | Tel: (530) 842-4121 | Fax: (530) 841-2049 |
| Administrative Mailing Address | 444 BRUCE ST, YREKA, CA, 96097-3450 |
| Enumeration & Last Sync | Enumerated: 2017-10-27 | CMS Record Updated: 2020-04-20 |
Clinic Location, Accessibility & Directions
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Plain-English Taxonomy & CMS Crosswalk (367500000X)
What Does Taxonomy Code 367500000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 367500000X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (SAMUEL C BIRKHOLZ)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
367500000X — Nurse Anesthetist, Certified RegisteredPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered | State: CA | License: 95000789 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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