NPIMap

Organization Active NPI

Acacia Family Medical Group

  • Family Medicine Physician
  • Salinas, CA
National Provider Identifier
1871603258
Registry record updated Aug 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ACACIA FAMILY MEDICAL GROUP
Practice address
400 E Romie LN
Salinas, CA 93901-4017
Phone
(831) 770-0123
Fax
(831) 770-1599
NPI assigned
Aug 30, 2006
Last updated
Aug 9, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2010

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

Authorized official

Name
Dr. Sumana Reddy, M.D.NPI 1336259738
Title
President
Phone
(831) 770-0123

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary
Obstetrics & Gynecology Physician 207V00000X NU

Addresses

Primary practice location

400 E Romie LN
Salinas, CA 93901-4017

Mailing address

400 E Romie LN
Salinas, CA 93901-4017
Phone (831) 770-0123

Other identifiers 1

IdentifierTypeStateIssuer
GR0083010MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040617001213 CA Part B Supplier - Clinic/Group Practice 6507840394 Receives reassigned benefits from 8 practitioners
1 other NPI on this enrollment
Practice locations: Salinas, CA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

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": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281312000000",
    "number": "1871603258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E ROMIE LN",
            "city": "SALINAS",
            "state": "CA",
            "postal_code": "939014017",
            "telephone_number": "831-770-0123",
            "fax_number": "831-770-1599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E ROMIE LN",
            "city": "SALINAS",
            "state": "CA",
            "postal_code": "939014017",
            "telephone_number": "831-770-0123",
            "fax_number": "831-770-1599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACACIA FAMILY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2010-08-09",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "SUMANA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "831-770-0123",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0083010",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salinas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 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.