NPIMap

Organization Active NPI

First Choice Physician Partners

Doing business as Greater Modesto Medical Surgical Associates

  • Otolaryngology Physician
  • Modesto, CA
National Provider Identifier
1477810323
Registry record updated Jun 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
FIRST CHOICE PHYSICIAN PARTNERS
Doing business as
Greater Modesto Medical Surgical Associates
Practice address
1541 Florida Ave
Ste 304
Modesto, CA 95350-4429
Phone
(209) 577-3388
Fax
(209) 523-0764
NPI assigned
Apr 17, 2012
Last updated
Jun 6, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
FIRST CHOICE PHYSICIAN PARTNERSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 6, 2016

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

Authorized official

Name
Mr. Jeff Koury
Title
Ceo
Phone
(714) 428-6842

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X NU Primary

Addresses

Primary practice location

1541 Florida Ave
Ste 304
Modesto, CA 95350-4429

Mailing address

1541 Florida Ave
Ste. 200
Modesto, CA 95350-4429
Phone (209) 214-7053

Other names 1

  • Greater Modesto Medical Surgical Associates Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120710000480 CA Part B Supplier - Clinic/Group Practice 0941465322 Receives reassigned benefits from 479 practitioners
24 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 24

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

View all 24

National Provider Directory

National Provider Directory
Part of
First Choice Physician Part

NPI Registry JSON

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

{
    "created_epoch": "1334620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465171200000",
    "number": "1477810323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1541 FLORIDA AVE",
            "address_2": "STE. 200",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504429",
            "telephone_number": "209-214-7053",
            "fax_number": "714-428-2315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 FLORIDA AVE",
            "address_2": "STE 304",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504429",
            "telephone_number": "209-577-3388",
            "fax_number": "209-523-0764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST CHOICE PHYSICIAN PARTNERS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FIRST CHOICE PHYSICIAN PARTNERS",
        "enumeration_date": "2012-04-17",
        "last_updated": "2016-06-06",
        "status": "A",
        "authorized_official_last_name": "KOURY",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-428-6842",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greater Modesto Medical Surgical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2016; 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.