Organization Active NPI

Allergy and Asthmatic Disease a Medical Group, Inc

  • Specialist
  • Rancho Mirage, CA
National Provider Identifier
1619197381
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G27030 Issued in CA
Legal business name
ALLERGY AND ASTHMATIC DISEASE A MEDICAL GROUP, INC
Practice address
39000 Bob Hope Dr
Wright BLDG #100
Rancho Mirage, CA 92270-3221
Phone
(760) 568-3595
Fax
(760) 779-8671
NPI assigned
Apr 26, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Pat Markall
Title
Insurance Biller
Phone
(762) 568-3595

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X G27030 CA Primary

Addresses

Primary practice location

39000 Bob Hope Dr
Wright BLDG #100
Rancho Mirage, CA 92270-3221

Mailing address

39000 Bob Hope Dr
Wright BLDG #100
Rancho Mirage, CA 92270-3221
Phone (760) 568-3595

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090102000155 CA Part B Supplier - Clinic/Group Practice 2769544188 Receives reassigned benefits from 1 practitioner
Practice locations: Rancho Mirage, CA

National Provider Directory

National Provider Directory

Locations

39000 Bob Hope Dr
Bldg 100
Rancho Mirage, CA 92270
Phone (760) 568-3595

39000 Bob Hope Dr
Ste W100
Rancho Mirage, CA 92270
Phone (760) 568-3595

39935 Vista del Sol
Ste 100
Rancho Mirage, CA 92270
Phone (760) 568-3595

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 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.

NPI Registry JSON

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619197381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39000 BOB HOPE DR",
            "address_2": "WRIGHT BLDG #100",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922703221",
            "telephone_number": "760-568-3595",
            "fax_number": "760-779-8671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39000 BOB HOPE DR",
            "address_2": "WRIGHT BLDG #100",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922703221",
            "telephone_number": "760-568-3595",
            "fax_number": "760-779-8671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLERGY AND ASTHMATIC DISEASE A MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARKALL",
        "authorized_official_first_name": "PAT",
        "authorized_official_title_or_position": "INSURANCE BILLER",
        "authorized_official_telephone_number": "762-568-3595",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G27030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Mirage, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.