NPIMap

Organization Active NPI

Greater Modesto Medical Surgical Associates, Inc.

Doing business as McHenry Medical Group

  • Urology Physician
  • Turlock, CA
National Provider Identifier
1407080823
Registry record updated Oct 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
GREATER MODESTO MEDICAL SURGICAL ASSOCIATES, INC.
Doing business as
McHenry Medical Group
Practice address
1000 Delbon Ave
#2
Turlock, CA 95382-2008
Phone
(209) 577-3388
Fax
(209) 342-3743
NPI assigned
May 13, 2009
Last updated
Oct 5, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2009

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

Authorized official

Name
Mr. John R Porteous, M.D.NPI 1669460630
Title
Shareholder
Phone
(209) 577-3388

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208800000X Primary
Pediatric Urology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2088P0231X

Addresses

Primary practice location

1000 Delbon Ave
#2
Turlock, CA 95382-2008

Mailing address

1541 Florida Ave
Suite 200
Modesto, CA 95350-4429
Phone (209) 577-3388

Other names 1

  • McHenry Medical Group Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1242172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254700800000",
    "number": "1407080823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1541 FLORIDA AVE",
            "address_2": "SUITE 200",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504429",
            "telephone_number": "209-577-3388",
            "fax_number": "209-342-3743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 DELBON AVE",
            "address_2": "#2",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "953822008",
            "telephone_number": "209-577-3388",
            "fax_number": "209-342-3743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER MODESTO MEDICAL SURGICAL ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-13",
        "last_updated": "2009-10-05",
        "status": "A",
        "authorized_official_last_name": "PORTEOUS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "SHAREHOLDER",
        "authorized_official_telephone_number": "209-577-3388",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2088P0231X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology, Pediatric Urology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "McHenry Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Turlock, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2009; 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.