NPIMap

Legacy MD Medical Group Inc

A Medicare group practice based in El Centro, CA: 3 NPIs enrolled under one PECOS associate control ID (PAC ID 0446619738), with 48 clinicians.

Medicare enrollment

Medicare enrollment files
PAC ID
0446619738The PECOS associate control ID: one enrolled organization, which may hold several NPIs
Provider type
DME Supplier - Physician - General Surgery, Part B Supplier - Clinic/Group Practice, Part B Supplier - Independent Diagnostic Testing Facility (Idtf), Part B Supplier - Intensive Cardiac Rehabilitation
Enrolled in
CA
Enrollments
5
Group size
12 cliniciansAs Care Compare reports it
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Practice locations
13In 6 places

Enrollment records 5

Enrollment IDStateProvider typeNPI
O20230705001455 CA Part B Supplier - Clinic/Group Practice 1073210753
O20250630003795 CA DME Supplier - Physician - General Surgery 1073210753
O20250127000040 CA Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 1063251502
O20240806001131 CA Part B Supplier - Intensive Cardiac Rehabilitation 1285494351
O20240701000151 CA Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 1063251502

NPIs in this group 3

NPPES NPI Registry

These NPI records belong to the same enrolled organization. Each has its own page.

Practice locations

Locations on the Medicare enrollment

Clinicians 48

Clinicians who reassign their Medicare benefits to this group (47) or whom Care Compare lists as members (12).

Sources for this page