Organization Active NPI

Alex Harrison, M.D., Inc.

  • Cardiovascular Disease Physician
  • Santa Maria, CA
National Provider Identifier
1497995401
Registry record updated Feb 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
A89322 Issued in CA
Legal business name
ALEX HARRISON, M.D., INC.
Practice address
1510 E Main St
Ste 101
Santa Maria, CA 93454-4826
Phone
(805) 928-0610
NPI assigned
Mar 3, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2012

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

Authorized official

Name
Alexander T Harrison, M.D.
Title
President
Phone
(805) 928-0610

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X A89322 CA Primary

Addresses

Primary practice location

1510 E Main St
Ste 101
Santa Maria, CA 93454-4826

Mailing address

1510 E Main St
Ste 101
Santa Maria, CA 93454-4826
Phone (805) 928-0610

Other identifiers 1

IdentifierTypeStateIssuer
1497995401MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090914000573 CA Part B Supplier - Clinic/Group Practice 4587710751 Receives reassigned benefits from 2 practitioners
Practice locations: Santa Maria, CA

National Provider Directory

National Provider Directory

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1236038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329868800000",
    "number": "1497995401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 E MAIN ST",
            "address_2": "STE 101",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934544826",
            "telephone_number": "805-928-0610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 E MAIN ST",
            "address_2": "STE 101",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934544826",
            "telephone_number": "805-928-0610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALEX HARRISON, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-03",
        "last_updated": "2012-02-22",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-928-0610",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A89322",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1497995401",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Maria, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2012; 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.