Modern Neurocare Medical Center

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

A86600 Issued in CA

Legal business name

MODERN NEUROCARE MEDICAL CENTER

Practice address

1801 E March LN
Suite B-220
Stockton, CA 95210-6629

Phone

(209) 951-8830

Fax

(209) 951-8831

NPI assigned

Jul 18, 2006

Organization subpart

No

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

Authorized official

Name

Madan Prasad, MDNPI 1639198054

Title

President/Ceo

Phone

(209) 951-8830

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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.

• Madan Prasad, M.D.

  • Neurology Physician
  • Stockton, CA
  • NPI 1639198054
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544140800000",
    "number": "1366461782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7393",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952670393",
            "telephone_number": "209-951-8830",
            "fax_number": "209-951-8831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 E MARCH LN",
            "address_2": "SUITE B-220",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952106629",
            "telephone_number": "209-951-8830",
            "fax_number": "209-951-8831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN NEUROCARE MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-18",
        "last_updated": "2018-12-07",
        "status": "A",
        "authorized_official_last_name": "PRASAD",
        "authorized_official_first_name": "MADAN",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "209-951-8830",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A86600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A866000",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Delmar Mobley, DDS
• Mary Kathryn Mockler, D.P.T
• Cynthia A Mocko, PSYCHIATRIC TECH
• James Michael Mocko
• Savannah Mocko
• Marque D Modica
• Tashelle Toni Moffett
• Nadesh A Mofor
• Rayan Ibrahim Mohamed
• Asad Sarwath Mohammad Jani, MD

• Neurology Physician in Stockton, CA
• Providers in Stockton, CA by specialty
• Neurology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2018; 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.