NPIMap

Organization Active NPI

First Choice Physician Partners

Doing business as Greater Modesto Medical Surgical Associates

  • Neurological Surgery Physician
  • Modesto, CA
National Provider Identifier
1104183052
Registry record updated Jun 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
FIRST CHOICE PHYSICIAN PARTNERS
Doing business as
Greater Modesto Medical Surgical Associates
Practice address
205 W Granger Ave
Ste. D
Modesto, CA 95350-4402
Phone
(209) 571-0288
Fax
(209) 571-0327
NPI assigned
Apr 17, 2012
Last updated
Jun 6, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
FIRST CHOICE PHYSICIAN PARTNERSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 6, 2016

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

Authorized official

Name
Mr. Jeff Koury
Title
Ceo
Phone
(714) 428-6842

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X Primary

Addresses

Primary practice location

205 W Granger Ave
Ste. D
Modesto, CA 95350-4402

Mailing address

1541 Florida Ave
Ste. 200
Modesto, CA 95350-4429
Phone (209) 214-7053

Other names 1

  • Greater Modesto Medical Surgical Associates Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120710000480 CA Part B Supplier - Clinic/Group Practice 0941465322 Receives reassigned benefits from 479 practitioners
24 other NPIs on this enrollment

Other NPIs on the same Medicare enrollment 24

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

View all 24

National Provider Directory

National Provider Directory
Part of
First Choice Physician Part

Locations

1541 Florida Ave
Ste 100
Modesto, CA 95350
Phone (209) 575-3839

Practitioners & affiliated clinicians

Practitioners 628

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 628

NPI Registry JSON

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

{
    "created_epoch": "1334620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465171200000",
    "number": "1104183052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1541 FLORIDA AVE",
            "address_2": "STE. 200",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504429",
            "telephone_number": "209-214-7053",
            "fax_number": "714-428-2315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 W GRANGER AVE",
            "address_2": "STE. D",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504402",
            "telephone_number": "209-571-0288",
            "fax_number": "209-571-0327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST CHOICE PHYSICIAN PARTNERS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FIRST CHOICE PHYSICIAN PARTNERS",
        "enumeration_date": "2012-04-17",
        "last_updated": "2016-06-06",
        "status": "A",
        "authorized_official_last_name": "KOURY",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-428-6842",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greater Modesto Medical Surgical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2016; 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.