Atlantic Urology Medical Group Inc

Primary specialty

SpecialistTaxonomy code 174400000X

License

A32052 Issued in CA

Legal business name

ATLANTIC UROLOGY MEDICAL GROUP INC

Practice address

701 E 28TH St
Suite 319
Long Beach, CA 90806-2759

Phone

(562) 595-5977

Fax

(562) 490-0509

NPI assigned

Oct 1, 2007

Last updated

Aug 27, 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

Wendy Solis

Title

Office Manager

Phone

(562) 595-5977

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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.

• Barton Harris Wachs, M.D.

  • Specialist
  • Long Beach, CA
  • NPI 1366461832
  Medicare reassignment

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

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566864000000",
    "number": "1467649764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 E 28TH ST",
            "address_2": "SUITE 319",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062759",
            "telephone_number": "562-595-5977",
            "fax_number": "562-490-0509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E 28TH ST",
            "address_2": "SUITE 319",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062759",
            "telephone_number": "562-595-5977",
            "fax_number": "562-490-0509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC UROLOGY MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-01",
        "last_updated": "2019-08-27",
        "status": "A",
        "authorized_official_last_name": "SOLIS",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "562-595-5977"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "A32052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2405716",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "W9927",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Atlantic Recovery Services
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• Atlantis Cbas, Inc
• Atlarhea Physical Therapy Service
• Vidya Atluri, MD
• Friday Attah
• Frank J Attenello, MD

• Specialist in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.