Organization Active NPI

Family Medicine Associates of Northridge a Medical Group Inc

  • Family Medicine Physician
  • Northridge, CA
National Provider Identifier
1104984327
Registry record updated May 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FAMILY MEDICINE ASSOCIATES OF NORTHRIDGE A MEDICAL GROUP INC
Practice address
18350 Roscoe Blvd
Suite 600
Northridge, CA 91325
Phone
(818) 727-1515
Fax
(818) 727-7997
NPI assigned
Dec 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2025

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

Authorized official

Name
Dr. Elizabeth Eddy-Bertrand, MD
Title
President
Phone
(818) 727-1515

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

18350 Roscoe Blvd
Suite 600
Northridge, CA 91325

Mailing address

18350 Roscoe Blvd
Suite 600
Northridge, CA 91325
Phone (818) 727-1515

Other identifiers 1

IdentifierTypeStateIssuer
GR0061720MedicaidCA

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
05D0916950Family Medicine Associates-Northridge18350 Roscoe Boulevard, #600, Northridge, CA 91325Provider-performed microscopyApr 30, 2027

National Provider Directory

National Provider Directory

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748390400000",
    "number": "1104984327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18350 ROSCOE BLVD",
            "address_2": "SUITE 600",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "91325",
            "telephone_number": "818-727-1515",
            "fax_number": "818-727-7997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18350 ROSCOE BLVD",
            "address_2": "SUITE 600",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "91325",
            "telephone_number": "818-727-1515",
            "fax_number": "818-727-7997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MEDICINE ASSOCIATES OF NORTHRIDGE A MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A",
        "authorized_official_last_name": "EDDY-BERTRAND",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-727-1515",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0061720",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Northridge, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.