| Newstart Medical Group Inc | |
|
20601 West Paoli Lane Weimar CA 95736-0486 | |
| (530) 296-4417 | |
| (877) 425-5508 |
| Full Name | Newstart Medical Group Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 20601 West Paoli Lane, Weimar, California |
| Authorized Official Name and Position | Roger Gallant (MEDICAL DIRECTOR) |
| Authorized Official Contact | 2526198911 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Newstart Medical Group Inc Po Box 486 Weimar CA 95736-0486 Ph: (530) 296-4417 | Newstart Medical Group Inc 20601 West Paoli Lane Weimar CA 95736-0486 Ph: (530) 296-4417 |
| NPI Number | 1588072698 |
|---|---|
| Provider Enumeration Date | 08/01/2014 |
| Last Update Date | 05/27/2025 |
| Medicare PECOS PAC ID | 8628299799 |
|---|---|
| Medicare Enrollment ID | O20141015001437 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588072698 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Jack C Lane |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528037793 PECOS PAC ID: 2466357900 Enrollment ID: I20031205000767 |
| Provider Name | Sergio R Riffel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619018066 PECOS PAC ID: 9830175215 Enrollment ID: I20040625001161 |
| Provider Name | Randall L Steffens |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992745079 PECOS PAC ID: 7517995681 Enrollment ID: I20070605000497 |
| Provider Name | Monte W Penner |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1932321643 PECOS PAC ID: 6507943388 Enrollment ID: I20080403000075 |
| Provider Name | Mark E Knoble |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174617799 PECOS PAC ID: 1658431192 Enrollment ID: I20081113000648 |
| Provider Name | Mihaela M Hasse |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073624201 PECOS PAC ID: 5799839445 Enrollment ID: I20090815000025 |
| Provider Name | Marie T Georges |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245353309 PECOS PAC ID: 6406937804 Enrollment ID: I20090922000702 |
| Provider Name | Judith A Ramsey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447300801 PECOS PAC ID: 8921902859 Enrollment ID: I20100107000527 |
| Provider Name | Andrew T Kuninobu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548318538 PECOS PAC ID: 2466584305 Enrollment ID: I20100713000365 |
| Provider Name | Randall D Hensley |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1174622575 PECOS PAC ID: 2860684578 Enrollment ID: I20101012001262 |
| Provider Name | Hienvu C Nguyen |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1417035171 PECOS PAC ID: 7214111855 Enrollment ID: I20110406000541 |
| Provider Name | Roger D Gallant |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1215077102 PECOS PAC ID: 4486557253 Enrollment ID: I20110826000451 |
| Provider Name | Caryn Margaret Banque |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1477685253 PECOS PAC ID: 6608039987 Enrollment ID: I20120524000164 |
| Provider Name | Dustin R Varesko |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1568753887 PECOS PAC ID: 1153568027 Enrollment ID: I20150601000588 |
| Provider Name | Adam Bills |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1053602540 PECOS PAC ID: 7113157538 Enrollment ID: I20170912003369 |
| Provider Name | Brian Glass |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396176202 PECOS PAC ID: 4486920279 Enrollment ID: I20171023001942 |
| Provider Name | Anabel S Facemire |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1427043280 PECOS PAC ID: 2567438898 Enrollment ID: I20180216000896 |
| Provider Name | Edwin E Nebblett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558352963 PECOS PAC ID: 3173652716 Enrollment ID: I20180523000684 |
| Provider Name | Sonja D Derose |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558849661 PECOS PAC ID: 7113271180 Enrollment ID: I20181109000540 |
| Provider Name | Victoria S Razgunas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609359892 PECOS PAC ID: 1355687351 Enrollment ID: I20190117003646 |
| Provider Name | James Hilton Thomas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437602273 PECOS PAC ID: 7214263276 Enrollment ID: I20191221000587 |
| Provider Name | Samantha B Abbade |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710446133 PECOS PAC ID: 6709213861 Enrollment ID: I20200302001311 |
| Provider Name | Hiroko Furo |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1386087849 PECOS PAC ID: 8022304526 Enrollment ID: I20201228002570 |
| Provider Name | Irina Shchedrov |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669067013 PECOS PAC ID: 2466860820 Enrollment ID: I20210423000619 |
| Provider Name | Miriam R Feese |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003270505 PECOS PAC ID: 4284043027 Enrollment ID: I20210507002361 |
| Provider Name | Stephen Sparks |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1326292640 PECOS PAC ID: 0840695698 Enrollment ID: I20210817004114 |
| Provider Name | Daphne L. Huang |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1598012395 PECOS PAC ID: 7416347851 Enrollment ID: I20211129002690 |
| Provider Name | Ruth S Forde |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598932345 PECOS PAC ID: 4981887734 Enrollment ID: I20220411001574 |
| Provider Name | Nicole F Lescher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285025486 PECOS PAC ID: 0042607855 Enrollment ID: I20220426001797 |
| Provider Name | Sheila Ann Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013384577 PECOS PAC ID: 9638453137 Enrollment ID: I20220720003458 |
| Provider Name | Joel S Sabangan |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1871520908 PECOS PAC ID: 6002713237 Enrollment ID: I20220728001662 |
| Provider Name | Natalie Ecliseria Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366162943 PECOS PAC ID: 2961888599 Enrollment ID: I20221004003274 |
| Provider Name | Joshua A Arvizu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255968590 PECOS PAC ID: 9335505650 Enrollment ID: I20230511002028 |
| Provider Name | Melissa L Binus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427433457 PECOS PAC ID: 4587027750 Enrollment ID: I20230906000915 |
| Provider Name | Natasha V Jackson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952641805 PECOS PAC ID: 7416201983 Enrollment ID: I20240226003885 |
| Provider Name | Samuel Kim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750146536 PECOS PAC ID: 3375984537 Enrollment ID: I20240518000605 |
| Provider Name | Reynald V Forde |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932269842 PECOS PAC ID: 7911932421 Enrollment ID: I20240604000907 |
| Provider Name | Ava Cecilia Hudson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346603198 PECOS PAC ID: 9234558545 Enrollment ID: I20240916000067 |