Provident Primary Care Inc
NPI 1154785517 · Primary Care Clinic/Center · Merced, CA
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Provident Primary Care Inc is a Primary Care Clinic/Center organization in Merced, CA (NPI 1154785517).
Provider details
- NPI number
- 1154785517
- Entity type
- Organization
- Primary specialty
- Primary Care Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Jerry Tiu, Ceo(209) 384-4400
Specialties & taxonomies
Ambulatory Health Care Facilities
- Pulmonary Disease Physician207RP1001X
Allopathic & Osteopathic Physicians
- Podiatrist213E00000X
Podiatric Medicine & Surgery Service Providers
- Primary Care Nurse Practitioner363LP2300X
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
3 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (2)
- 450 E Yosemite Ave Ste aMerced, CA 95340-8429Phone: (209) 725-1112Fax: (209) 580-4863
- 410 E Yosemite Ave Ste aMerced, CA 95340-8220Phone: (209) 384-9108Fax: (209) 384-0580
Registry dates
- Enumerated
- 2016-04-11
- Last updated
- 2021-10-12
- Certified
- 2021-10-12
Frequently asked questions
- What is Provident Primary Care Inc's NPI number?
- Provident Primary Care Inc's National Provider Identifier (NPI) is 1154785517, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Provident Primary Care Inc?
- Provident Primary Care Inc is classified in the NPPES registry as Primary Care Clinic/Center (Ambulatory Health Care Facilities).
- Where is Provident Primary Care Inc located?
- Provident Primary Care Inc's practice location on file with NPPES is 3349 G St Ste C, Merced, CA 95340-0978.
- What is Provident Primary Care Inc's phone number?
- The practice phone number listed in the NPPES registry for Provident Primary Care Inc is (209) 580-4638.
- Does Provident Primary Care Inc accept Medicare?
- Provident Primary Care Inc is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Provident Primary Care Inc?
- The authorized official listed on Provident Primary Care Inc's NPPES record is Jerry Tiu, Ceo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Provident Primary Care Inc's NPI active?
- Yes — Provident Primary Care Inc's NPI (1154785517) is active in the NPPES registry as of the last update on 2021-10-12.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.