NPIMap

Organization Active NPI

Family Health Care Medical Group of Modesto a Professional Corp

  • Family Medicine Physician
  • Modesto, CA
National Provider Identifier
1912967787
Registry record updated Sep 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FAMILY HEALTH CARE MEDICAL GROUP OF MODESTO A PROFESSIONAL CORP
Practice address
1320 Celeste Dr
Modesto, CA 95355-2402
Phone
(209) 527-6900
Fax
(209) 524-7328
NPI assigned
Mar 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2015

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

Authorized official

Name
James L Shiovitz, M.D.NPI 1194792523
Title
Physician/Owner
Phone
(209) 527-6900

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 1

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

Addresses

Primary practice location

1320 Celeste Dr
Modesto, CA 95355-2402

Mailing address

1320 Celeste Dr
Modesto, CA 95355-2402
Phone (209) 527-6900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090507000048 CA Part B Supplier - Clinic/Group Practice 8729025879 Receives reassigned benefits from 10 practitioners
Practice locations: Modesto, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0610684Family Health Care Medical Group1320 Celeste Dr, Modesto, CA 95355Provider-performed microscopyDec 22, 2027

National Provider Directory

National Provider Directory

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)…

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JGEHCD

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441152000000",
    "number": "1912967787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 CELESTE DR",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953552402",
            "telephone_number": "209-527-6900",
            "fax_number": "209-524-7328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 CELESTE DR",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953552402",
            "telephone_number": "209-527-6900",
            "fax_number": "209-524-7328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTH CARE MEDICAL GROUP OF MODESTO A PROFESSIONAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-24",
        "last_updated": "2015-09-02",
        "status": "A",
        "authorized_official_last_name": "SHIOVITZ",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "209-527-6900",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.