NPIMap

Organization Active NPI

Midtown Medical Corporation

  • Health Maintenance Organization
  • Los Angeles, CA
National Provider Identifier
1043824212
Registry record updated Sep 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
Legal business name
MIDTOWN MEDICAL CORPORATION
Practice address
1267 N Virgil Ave
Los Angeles, CA 90029-2017
Phone
(323) 664-7628
NPI assigned
Sep 3, 2020
Last updated
Sep 3, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2020

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

Authorized official

Name
Ronald Shigematsu, MD
Title
President
Phone
(760) 941-7309

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X Primary

Addresses

Primary practice location

1267 N Virgil Ave
Los Angeles, CA 90029-2017

Mailing address

17215 Studebaker Rd Ste 320
Cerritos, CA 90703-2522
Phone (760) 941-7309

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210927001858 CA Part B Supplier - Clinic/Group Practice 8123425634 Receives reassigned benefits from 3 practitioners
Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory

Locations

17215 Studebaker Rd
Ste 320
Cerritos, CA 90703

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24860/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 5

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": "1599091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599091200000",
    "number": "1043824212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17215 STUDEBAKER RD STE 320",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907032522",
            "telephone_number": "760-941-7309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1267 N VIRGIL AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900292017",
            "telephone_number": "323-664-7628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDTOWN MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-03",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-02",
        "status": "A",
        "authorized_official_last_name": "SHIGEMATSU",
        "authorized_official_first_name": "RONALD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-941-7309",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.