NPIMap

Organization Active NPI

Merced Faculty Associates Medical Group, Incorporated

Doing business as MFA G Street

  • Family Medicine Physician
  • Merced, CA
National Provider Identifier
1003231341
Registry record updated Sep 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MERCED FACULTY ASSOCIATES MEDICAL GROUP, INCORPORATED
Doing business as
MFA G Street
Practice address
3393 G St
Suite C
Merced, CA 95340-0964
Phone
(209) 725-7149
NPI assigned
Feb 24, 2014
Last updated
Sep 29, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Rebecca Shaw
Title
Ceo
Phone
(209) 761-4555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X CA Primary

Addresses

Primary practice location

3393 G St
Suite C
Merced, CA 95340-0964

Mailing address

PO Box 3768
Merced, CA 95344-3768
Phone (209) 725-7149

Other names 1

  • MFA G Street Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040409000199 CA Part B Supplier - Clinic/Group Practice 4789678111 Receives reassigned benefits from 49 practitioners
15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Atwater, CA; Merced, CA; Livingston, CA; Hilmar, CA; Delhi, CA

Other NPIs on the same Medicare enrollment 15

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 15

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2078496Mfa G Street3393 G St Ste C, Merced, CA 95340Provider-performed microscopyMay 28, 2028

National Provider Directory

National Provider Directory
Tax ID family
Merced Faculty Associates Medical Group Incorporated10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3012/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1393200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443484800000",
    "number": "1003231341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3768",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953443768",
            "telephone_number": "209-725-7149",
            "fax_number": "209-726-0259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3393 G ST",
            "address_2": "SUITE C",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953400964",
            "telephone_number": "209-725-7149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCED FACULTY ASSOCIATES MEDICAL GROUP, INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-24",
        "last_updated": "2015-09-29",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "209-761-4555"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MFA G Street",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Merced, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.