Individual provider Active NPI

Maciej Gerard Ossowski, M. D.

  • Family Medicine Physician
  • Merced, CA
National Provider Identifier
1346207883
Registry record updated Jul 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
00A383800 Issued in CA
Practice address
3349 G St Ste D
Suite D
Merced, CA 95340-0978
Phone
(209) 722-8040
Fax
(209) 722-0287
NPI assigned
Apr 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 00A383800 CA Primary

Addresses

Primary practice location

3349 G St Ste D
Suite D
Merced, CA 95340-0978

Mailing address

3349 G St Ste D
Suite D
Merced, CA 95340-0978
Phone (209) 722-8040

Other identifiers 1

IdentifierTypeStateIssuer
1740575182OtherCANPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110620000592 CA Practitioner - Family Practice 3173701299 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1973
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Provident Primary Care IncGroup PAC ID 8628350873, 10 clinicians

Practice addresses (Care Compare)

3349 G St
Suite C
Merced, CA 95340-0978
Phone (209) 580-4638

Hospital & facility affiliations

  • Valley Home Health Home health agency, Fresno, CA, CCN 059227

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
100
Improvement activities
40
Cost
84.05

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
00A383800CAMDFamily Medicine Physician
38380CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Provident Primary Care Inc CurrentSince May 19, 2019 Accepting new patients
Dignity Health Past Accepting new patients

Locations

410 E Yosemite Ave
Ste A
Merced, CA 95340
Phone (209) 384-9108

3349 G St
Ste C
Merced, CA 95340
Phone (209) 384-4400

3349 G St
Ste D
Merced, CA 95340
Phone (209) 722-8040

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: ossowski.maciej.006.0050857@ppc.meditab.direct-ci.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342656000000",
    "number": "1346207883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3349 G ST STE D",
            "address_2": "SUITE D",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953400978",
            "telephone_number": "209-722-8040",
            "fax_number": "209-722-0287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3349 G ST STE D",
            "address_2": "SUITE D",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953400978",
            "telephone_number": "209-722-8040",
            "fax_number": "209-722-0287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSSOWSKI",
        "first_name": "MACIEJ",
        "middle_name": "GERARD",
        "name_prefix": "Dr.",
        "credential": "M. D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2012-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "00A383800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1740575182",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Merced, CA

Sources for this page

Verify at the official NPI Registry.