Organization Active NPI

Partners Medical Group LLC

  • Family Medicine Physician
  • Cumberland, MD
National Provider Identifier
1669767331
Registry record updated Nov 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D14865 Issued in MD
Legal business name
PARTNERS MEDICAL GROUP LLC
Practice address
200 Glenn St
Suite 201
Cumberland, MD 21502-2573
Phone
(301) 777-2696
Fax
(301) 777-1049
NPI assigned
Jun 10, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2011

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

Authorized official

Name
Dr. Robustiano J Barrera Jr., MD
Title
Medical Director
Phone
(941) 916-2168

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X D14865 MD Primary

Addresses

Primary practice location

200 Glenn St
Suite 201
Cumberland, MD 21502-2573

Mailing address

200 Glenn St
Suite 302
Cumberland, MD 21502-2573
Phone (301) 777-2696

Other identifiers 1

IdentifierTypeStateIssuer
002011700MedicaidMD

National Provider Directory

National Provider Directory

Locations

200 Glenn St
Ste 201
Cumberland, MD 21502
Phone (240) 580-1919

NPI Registry JSON

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

{
    "created_epoch": "1307664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322006400000",
    "number": "1669767331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 GLENN ST",
            "address_2": "SUITE 302",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215022573",
            "telephone_number": "301-777-2696",
            "fax_number": "301-777-1049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 GLENN ST",
            "address_2": "SUITE 201",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215022573",
            "telephone_number": "301-777-2696",
            "fax_number": "301-777-1049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARTNERS MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-10",
        "last_updated": "2011-11-23",
        "status": "A",
        "authorized_official_last_name": "BARRERA",
        "authorized_official_first_name": "ROBUSTIANO",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "941-916-2168",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D14865",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002011700",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumberland, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.