Organization Active NPI

Prime Care Medical, Inc.

  • Primary Care Clinic/Center
  • Naples, FL
National Provider Identifier
1770717381
Registry record updated Feb 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
ME 103428 Issued in FL
Legal business name
PRIME CARE MEDICAL, INC.
Practice address
5621 Strand Blvd Ste 206
Naples, FL 34110-7303
Phone
(239) 591-5979
Fax
(239) 308-4547
NPI assigned
May 11, 2009
Last updated
Feb 16, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2018

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

Authorized official

Name
Sajid Wazir, M.D.
Title
President
Phone
(239) 591-5979

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X ME 103428 FL Primary

Addresses

Primary practice location

5621 Strand Blvd Ste 206
Naples, FL 34110-7303

Mailing address

3876 Gibralter Dr
Naples, FL 34119-8647
Phone (239) 597-0190

Other identifiers 1

IdentifierTypeStateIssuer
CS832AOtherFLMEDICARE PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100211000449 FL Part B Supplier - Clinic/Group Practice 0244373397 Receives reassigned benefits from 1 practitioner
Practice locations: Naples, FL

National Provider Directory

National Provider Directory

Locations

5621 Strand Blvd
Ste 206
Naples, FL 34110
Phone (239) 591-5979

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": "1242000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518739200000",
    "number": "1770717381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3876 GIBRALTER DR",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341198647",
            "telephone_number": "239-597-0190",
            "fax_number": "239-597-7312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5621 STRAND BLVD STE 206",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341107303",
            "telephone_number": "239-591-5979",
            "fax_number": "239-308-4547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME CARE MEDICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-11",
        "last_updated": "2018-02-16",
        "status": "A",
        "authorized_official_last_name": "WAZIR",
        "authorized_official_first_name": "SAJID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "239-591-5979",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "ME 103428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "CS832A",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2018; 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.