NPIMap

Organization Active NPI

Mark David Levine, M.D. Professional Corporation

Doing business as Community Psychiatry Associates, Inc.

  • Psychiatry Physician
  • Manteca, CA
National Provider Identifier
1366690398
Registry record updated Aug 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
MARK DAVID LEVINE, M.D. PROFESSIONAL CORPORATION
Doing business as
Community Psychiatry Associates, Inc.
Practice address
302 Cherry LN. Ste 208
Manteca, CA 95337-7319
Phone
(209) 823-2246
Fax
(209) 823-2251
NPI assigned
Sep 3, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2013

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

Authorized official

Name
Mark David Levine, MD
Title
President
Phone
(916) 576-7898

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

302 Cherry LN. Ste 208
Manteca, CA 95337-7319

Mailing address

3841 N Freeway Blvd
Suite 120
Sacramento, CA 95834-1949
Phone (916) 576-7898

Other names 1

  • Community Psychiatry Associates, Inc. Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120912000548 CA Part B Supplier - Clinic/Group Practice 0143478305 Receives reassigned benefits from 224 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 16

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

View all 16

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376956800000",
    "number": "1366690398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3841 N FREEWAY BLVD",
            "address_2": "SUITE 120",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958341949",
            "telephone_number": "916-576-7898",
            "fax_number": "916-285-0338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 CHERRY LN. STE 208",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953377319",
            "telephone_number": "209-823-2246",
            "fax_number": "209-823-2251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK DAVID LEVINE, M.D. PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-03",
        "last_updated": "2013-08-20",
        "status": "A",
        "authorized_official_last_name": "LEVINE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "916-576-7898",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Psychiatry Associates, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Manteca, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2013; 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.