NPIMap

Organization Active NPI

Perinatal & Pediatric Specialists Medical Group Inc.

Doing business as Childrens Specialist Medical Group of Sacramento

  • Specialist
  • Sacramento, CA
National Provider Identifier
1114007432
Registry record updated Jul 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
105882 Issued in CA
Legal business name
PERINATAL & PEDIATRIC SPECIALISTS MEDICAL GROUP INC.
Doing business as
Childrens Specialist Medical Group of Sacramento
Practice address
5301 F St
Ste 313
Sacramento, CA 95819-3226
Phone
(916) 736-6470
Fax
(916) 736-6798
NPI assigned
Oct 17, 2006
Last updated
Jul 24, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2007

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

Authorized official

Name
Dr. Andrew Wertz, MDNPI 1013909621
Title
President/Ceo
Phone
(916) 736-6470

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 105882 CA Primary

Addresses

Primary practice location

5301 F St
Ste 313
Sacramento, CA 95819-3226

Mailing address

5301 F St Ste 313
Sacramento, CA 95819-3222
Phone (916) 736-6470

Other names 1

  • Childrens Specialist Medical Group of Sacramento Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 28

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 28

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185235200000",
    "number": "1114007432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 F ST STE 313",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958193222",
            "telephone_number": "916-736-6470",
            "fax_number": "916-736-6798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 F ST",
            "address_2": "STE 313",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958193226",
            "telephone_number": "916-736-6470",
            "fax_number": "916-736-6798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERINATAL & PEDIATRIC SPECIALISTS MEDICAL GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-07-24",
        "status": "A",
        "authorized_official_last_name": "WERTZ",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "916-736-6470",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "105882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Childrens Specialist Medical Group of Sacramento",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.