Primary Care Associates Medical Group Inc

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

Legal business name

PRIMARY CARE ASSOCIATES MEDICAL GROUP INC

Practice address

1635 Lake San Marcos Dr Ste 201
San Marcos, CA 92078-4698

Phone

(760) 471-9444

Fax

(760) 471-4886

NPI assigned

Dec 5, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Wendy L Shirley

Title

Director Quality Managment

Phone

(760) 471-9444

Specialties & licenses 1

Addresses

Tax ID family

Coastal Orthopaedics Sports Medical Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Primary Care Associated Medical Group, Inc

  dba Coastal Orthopaedics & Sports Medical Group

  • Orthopaedic Surgery Physician
  • Encinitas, CA
  • NPI 1649426578
  NPD tax ID

Locations

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)…

Practitioners 1

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.

• Randy F Jones, PA

  • Physician Assistant
  • La Mesa, CA
  • NPI 1578508743
  NPD (past)

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184782724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 LAKE SAN MARCOS DR STE 201",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920784698",
            "telephone_number": "760-471-9444",
            "fax_number": "760-471-4886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 LAKE SAN MARCOS DR STE 201",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920784698",
            "telephone_number": "760-471-9444",
            "fax_number": "760-471-4886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE ASSOCIATES MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHIRLEY",
        "authorized_official_first_name": "WENDY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR QUALITY MANAGMENT",
        "authorized_official_telephone_number": "760-471-9444",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Amy M Price, MFT
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• Brandalyn Ann Prior
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• Project Athlete and Physical Therapy, Inc.
• Proresults Physical Therapy Inc.

• Exclusive Provider Organization in San Marcos, CA
• Providers in San Marcos, CA by specialty
• Exclusive Provider Organization in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.