Organization Active NPI

Prime Care Associates a Medical Corporation

  • Geriatric Medicine (Internal Medicine) Physician
  • Northridge, CA
National Provider Identifier
1508986738
Registry record updated May 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
PRIME CARE ASSOCIATES A MEDICAL CORPORATION
Practice address
18350 Roscoe Blvd
Suite # 218
Northridge, CA 91325-4109
Phone
(818) 993-6660
Fax
(818) 993-8158
NPI assigned
Mar 30, 2007
Last updated
May 11, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2010

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

Authorized official

Name
Mrs. Yasmin Kajani
Title
Office Manager
Phone
(818) 993-6660

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X NU Primary

Addresses

Primary practice location

18350 Roscoe Blvd
Suite # 218
Northridge, CA 91325-4109

Mailing address

18350 Roscoe Blvd
Suite # 218
Northridge, CA 91325-4109
Phone (818) 993-6660

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100511000174 CA Part B Supplier - Clinic/Group Practice 2860520913 Receives reassigned benefits from 2 practitioners
Practice locations: Northridge, 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, 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": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273536000000",
    "number": "1508986738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18350 ROSCOE BLVD",
            "address_2": "SUITE # 218",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913254109",
            "telephone_number": "818-993-6660",
            "fax_number": "818-993-8158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18350 ROSCOE BLVD",
            "address_2": "SUITE # 218",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913254109",
            "telephone_number": "818-993-6660",
            "fax_number": "818-993-8158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME CARE ASSOCIATES A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2010-05-11",
        "status": "A",
        "authorized_official_last_name": "KAJANI",
        "authorized_official_first_name": "YASMIN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "818-993-6660",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northridge, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2010; 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.