ADVENTIST HEALTH CALIFORNIA MEDICAL GROUP, INC. — NPI 1831486653 (Board-Certified Cardiologist (Heart & Blood Vessel Specialist) in CLEARLAKE, CA)

CMS-1500 Box 24J / 33a • NPI

1831486653

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

207RC0000X (CMS 06)

Board-Certified Cardiologist (Heart & Blood Vessel Specialist)

Box 32 Service Location & ZIP+4

15250 LAKESHORE DR, SUITE C, CLEARLAKE, CA, 95422-8107

✓ 9-Digit EDI 837 ZIP+4 (95422-8107)

Practice Phone & Referral Fax

(707) 995-3764

Fax: (707) 995-0904

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1831486653 (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	`1831486653` (NPI-2 Organization / Facility)
Provider / Legal Name	ADVENTIST HEALTH CALIFORNIA MEDICAL GROUP, INC.
Plain-English Specialty	Board-Certified Cardiologist (Heart & Blood Vessel Specialist) NUCC Code: `207RC0000X` (Internal Medicine, Cardiovascular Disease)
Certifying / Licensing Body	American Board of Internal Medicine — Cardiovascular Disease
Practice Location Address	15250 LAKESHORE DR, SUITE C, CLEARLAKE, CA, 95422-8107
Practice Telephone / Fax	Tel: (707) 995-3764 \| Fax: (707) 995-0904
Administrative Mailing Address	1001 ADAMS ST, SAINT HELENA, CA, 94574-1107
Enumeration & Last Sync	Enumerated: 2011-06-30 \| CMS Record Updated: 2011-06-30
Authorized Official	KAYE DONNELLY (Specialist, Contract Compliance)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

15250 LAKESHORE DR, SUITE C, CLEARLAKE, CA, 95422-8107

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Plain-English Taxonomy & CMS Crosswalk (207RC0000X)

What Does Taxonomy Code 207RC0000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207RC0000X translates to:
"Board-Certified Cardiologist (Heart & Blood Vessel Specialist)"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 06 (Physician/Cardiovascular Disease (Cardiology)) • CMS Code 11 (Physician/Internal Medicine)
Certifying / Accrediting Authority: American Board of Internal Medicine — Cardiovascular Disease
Clinical Scope: Chest pain (angina), palpitations, atrial fibrillation, heart murmurs, shortness of breath on exertion, resistant hypertension, or post-heart attack care.

Specialty Clinical Procedures & Therapeutic Classes

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

Typical CPT / Diagnostic Procedures:

Transthoracic Doppler Echocardiography (TTE — CPT 93306)
12-Lead Electrocardiogram (ECG) & Holter / Event Arrhythmia Monitoring
Exercise Treadmill & Myocardial Perfusion Nuclear Stress Testing
Diagnostic Coronary Angiography & Percutaneous Coronary Intervention (PCI)

Common Therapeutic Classes:

High-Intensity Statins (Atorvastatin, Rosuvastatin) & Ezetimibe
Beta-Blockers (Metoprolol Succinate, Carvedilol, Bisoprolol)
Sacubitril/Valsartan, Empagliflozin & Spironolactone (Heart Failure GDMT)
Apixaban, Rivaroxaban & Clopidogrel (Atrial Fibrillation & Stent Thrombosis Prevention)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`207RC0000X` — Internal Medicine, Cardiovascular Disease Plain English: Board-Certified Cardiologist (Heart & Blood Vessel 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 #1831486653)