Beverly Internal Medicine Medical Group Inc.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A53499 Issued in CA

Legal business name

BEVERLY INTERNAL MEDICINE MEDICAL GROUP INC.

Practice address

2614 W Beverly Blvd
Montebello, CA 90640-2310

Phone

(323) 728-0653

NPI assigned

Nov 12, 2007

Last updated

Feb 21, 2014By 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

Dr. Soumitra Sarkar, M.D.NPI 1578573010

Title

President

Phone

(323) 728-0653

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

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.

• Soumitra Sarkar, M.D.

  • Internal Medicine Physician
  • Montebello, CA
  • NPI 1578573010
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1194825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392940800000",
    "number": "1568642197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2614 W BEVERLY BLVD",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906402310",
            "telephone_number": "323-728-0653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2614 W BEVERLY BLVD",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906402310",
            "telephone_number": "323-728-0653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEVERLY INTERNAL MEDICINE MEDICAL GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-12",
        "last_updated": "2014-02-21",
        "status": "A",
        "authorized_official_last_name": "SARKAR",
        "authorized_official_first_name": "SOUMITRA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-728-0653",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A53499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110208996",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A534990",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Beverly Ambulatory Med-Surg Center, PC
• Beverly Care Medical Group, Inc
• Beverly Community Hospital Association (Beverly Hospital)
• Beverly Hospital
• Beverly Hospitalist Group Incorporated
• Beverly Oncology & Imaging Center Medical GR
• Beverly Orthopedic Laboratory Inc
• Beverly Orthopedic Physical Therapy Center Inc.
• Beverly Pediatric Medical Group, Inc.
• Beverly Plaza RX Inc

• Internal Medicine Physician in Montebello, CA
• Providers in Montebello, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2014; 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.