NPIMap

Organization Active NPI

Prima Medical Foundation

  • General Practice Physician
  • Novato, CA
National Provider Identifier
1285898601
Registry record updated Aug 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
G55637 Issued in CA
Legal business name
PRIMA MEDICAL FOUNDATION
Practice address
75 Rowland Way
Suite 100
Novato, CA 94945
Phone
(415) 897-9664
Fax
(415) 897-2446
NPI assigned
Jul 15, 2008
Organization subpart
Yes
Parent organization
PRIMA MEDICAL FOUNDATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 14, 2012

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

Authorized official

Name
Mr. Joel A. Criste
Title
Ceo
Phone
(415) 884-1840

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X G73388 CA
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X G55637 CA
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X A65187 CA
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X G55637 CA Primary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X

Addresses

Primary practice location

75 Rowland Way
Suite 100
Novato, CA 94945

Mailing address

4 Hamilton Landing
Suite 100
Novato, CA 94949
Phone (415) 884-1840

National Provider Directory

National Provider Directory
Tax ID family
Prima Medical Foundation19 organizations share this tax ID, including this one
Part of
Prima Medical Foundation

Other organizations with this tax ID 18

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

View all 18

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1216080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344902400000",
    "number": "1285898601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 HAMILTON LANDING",
            "address_2": "SUITE 100",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "94949",
            "telephone_number": "415-884-1840",
            "fax_number": "415-884-3510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 ROWLAND WAY",
            "address_2": "SUITE 100",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "94945",
            "telephone_number": "415-897-9664",
            "fax_number": "415-897-2446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMA MEDICAL FOUNDATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRIMA MEDICAL FOUNDATION",
        "enumeration_date": "2008-07-15",
        "last_updated": "2012-08-14",
        "status": "A",
        "authorized_official_last_name": "CRISTE",
        "authorized_official_first_name": "JOEL",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "415-884-1840",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "G73388",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G55637",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "CA",
            "license": "A65187",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "G55637",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Novato, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2012; 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.