NPIMap

Organization Active NPI

Merced Faculty Associates Medical Group Incorporated

Doing business as Express Health

  • Family Medicine Physician
  • Atwater, CA
National Provider Identifier
1215189477
Registry record updated Jun 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MERCED FACULTY ASSOCIATES MEDICAL GROUP INCORPORATED
Doing business as
Express Health
Practice address
1675 Bellevue Rd
Atwater, CA 95301-2608
Phone
(209) 356-3162
Fax
(209) 356-3165
NPI assigned
Oct 21, 2008
Last updated
Jun 3, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2010

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

Authorized official

Name
Rebecca Shaw
Title
Ceo
Phone
(209) 723-1920

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

1675 Bellevue Rd
Atwater, CA 95301-2608

Mailing address

PO Box 3768
Merced, CA 95344-3768
Phone (209) 725-7149

Other names 1

  • Express Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040409000199 CA Part B Supplier - Clinic/Group Practice 4789678111 Receives reassigned benefits from 49 practitioners
15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Atwater, CA; Merced, CA; Livingston, CA; Hilmar, CA; Delhi, CA

Other NPIs on the same Medicare enrollment 15

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

View all 15

National Provider Directory

National Provider Directory

Locations

1675 Bellevue Rd
Atwater, CA 95301
Phone (209) 356-3162

3605 Hospital Rd
Ste M
Atwater, CA 95301
Phone (209) 383-5500

19901 First St
Ste 4
Hilmar, CA 95324
Phone (209) 656-8701

3393 G St
Ste C
Merced, CA 95340
Phone (209) 580-4172

378 W Olive Ave
Ste B
Merced, CA 95348
Phone (209) 384-3024

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275523200000",
    "number": "1215189477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3768",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953443768",
            "telephone_number": "209-725-7149",
            "fax_number": "209-726-0259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 BELLEVUE RD",
            "city": "ATWATER",
            "state": "CA",
            "postal_code": "953012608",
            "telephone_number": "209-356-3162",
            "fax_number": "209-356-3165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCED FACULTY ASSOCIATES MEDICAL GROUP INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-21",
        "last_updated": "2010-06-03",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "209-723-1920"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Express Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Atwater, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2010; 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.