Pid Associates Medical Group Inc

Primary specialty

Pediatric Infectious Diseases PhysicianTaxonomy code 2080P0208X

License

A40896 Issued in CA

Legal business name

PID ASSOCIATES MEDICAL GROUP INC

Practice address

2801 Atlantic Ave
Long Beach, CA 90806-1701

Phone

(562) 933-8590

Fax

(562) 933-8093

NPI assigned

Sep 8, 2006

Last updated

Feb 12, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Audra Deveikis, M.D.NPI 1558461327

Title

Medical Director

Phone

(562) 933-8590

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

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.

• Audra Deveikis, M.D.

  • Pediatric Infectious Diseases Physician
  • Long Beach, CA
  • NPI 1558461327
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1157673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549929600000",
    "number": "1386748614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1536 W 25TH ST",
            "address_2": "PMB 163",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907324415",
            "telephone_number": "562-933-8590",
            "fax_number": "562-933-8093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 ATLANTIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908061701",
            "telephone_number": "562-933-8590",
            "fax_number": "562-933-8093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PID ASSOCIATES MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-08",
        "last_updated": "2019-02-12",
        "status": "A",
        "authorized_official_last_name": "DEVEIKIS",
        "authorized_official_first_name": "AUDRA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "562-933-8590",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2080P0208X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "CA",
            "license": "A40896",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCS/CHP NUMBER",
            "identifier": "CGP144665",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0041670",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph Ralph Piccola
• Gabrielle Pickens
• Gloria Picking, M.S.W. ; L.C.S.W.
• Jorge Arturo Pico, MD
• Jordan David Picou
• Gerianna Pierce
• Kammie Pierce, RN, PMHNP
• Conner Eric Pierra, DPT
• John Pierson
• Kathy Pierson

• Pediatric Infectious Diseases Physician in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Pediatric Infectious Diseases Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2019; 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.