NPIMap

Organization Active NPI

Legacy MD Medical Group Inc

  • General Practice Physician
  • El Centro, CA
National Provider Identifier
1073210753
Registry record updated Feb 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
LEGACY MD MEDICAL GROUP INC
Practice address
1699 N Imperial Ave
El Centro, CA 92243-1320
Phone
(760) 550-1685
Fax
(888) 631-5150
NPI assigned
Feb 13, 2023
Last updated
Feb 16, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2026

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

Authorized official

Name
John M Strong, MDNPI 1043248719
Title
President
Phone
(760) 550-1685

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X NU
Urgent Care Clinic/Center 261QU0200X NU
Durable Medical Equipment & Medical Supplies 332B00000X NU
General Practice Physician 208D00000X NU Primary
Behavior Analyst 103K00000X NU

Addresses

Primary practice location

1699 N Imperial Ave
El Centro, CA 92243-1320

Mailing address

1699 N Imperial Ave
El Centro, CA 92243-1320
Phone (760) 550-1685

Other practice location 1

222 E Cole Blvd Ste C
Calexico, CA 92231-3211
Phone (760) 550-1685

Other identifiers 1

IdentifierTypeStateIssuer
1043248719OtherCANPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20230705001455 CA Part B Supplier - Clinic/Group Practice 0446619738 Receives reassigned benefits from 48 practitioners
Practice locations: El Centro, CA; Indio, CA; Chula Vista, CA; Calexico, CA; Brawley, CA; Blythe, CA
O20250630003795 CA DME Supplier - Physician - General Surgery 0446619738 Practice locations: El Centro, CA

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Legacy MD Medical Group Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

690 Otay Lakes Rd
Ste 125
Chula Vista, CA 91910
Phone (760) 352-2551

1498 W Main St
El Centro, CA 92243
Phone (442) 283-3494

81812 Doctor Carreon Blvd
Ste E
Indio, CA 92201
Phone (442) 236-1498

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 50

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.

View all 50

NPI Registry JSON

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

{
    "created_epoch": "1676246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771200000000",
    "number": "1073210753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1699 N IMPERIAL AVE",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922431320",
            "telephone_number": "760-550-1685",
            "fax_number": "888-631-5150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1699 N IMPERIAL AVE",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922431320",
            "telephone_number": "760-550-1685",
            "fax_number": "888-631-5150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "222 E Cole Blvd Ste C",
            "address_purpose": "LOCATION",
            "city": "Calexico",
            "state": "CA",
            "postal_code": "922313211",
            "country_code": "US",
            "telephone_number": "760-550-1685",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LEGACY MD MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-13",
        "last_updated": "2026-02-16",
        "certification_date": "2026-02-16",
        "status": "A",
        "authorized_official_last_name": "STRONG",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-550-1685",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1043248719",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Centro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2026; 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.