NPIMap

Organization Active NPI

Osler Medical Group Inc

  • Internal Medicine Physician
  • Modesto, CA
National Provider Identifier
1952468035
Registry record updated Jun 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A65690 Issued in CA
Legal business name
OSLER MEDICAL GROUP INC
Practice address
1330 Nelson Ave
Suite C
Modesto, CA 95350-5341
Phone
(209) 846-9444
Fax
(209) 844-0309
NPI assigned
Jan 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2014

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

Authorized official

Name
Elliott Metcalfe, MD
Title
Owner
Phone
(209) 846-9444

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X A65690 CA Primary

Addresses

Primary practice location

1330 Nelson Ave
Suite C
Modesto, CA 95350-5341

Mailing address

1330 Nelson Ave
Suite C
Modesto, CA 95350-5341
Phone (209) 846-9444

Other identifiers 1

IdentifierTypeStateIssuer
GR0089790MedicaidCA

National Provider Directory

National Provider Directory

Locations

136 Glasson Way
Grass Valley, CA 95945
Phone (530) 274-0200

3430 Tully Rd
Ste 20231
Modesto, CA 95350
Phone (209) 300-4594

1330 Nelson Ave
Ste C
Modesto, CA 95350
Phone (209) 576-1547

648 Zion St
#B
Nevada City, CA 95959
Phone (530) 265-7850

Practitioners & affiliated clinicians

Practitioners 9

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": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402444800000",
    "number": "1952468035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 NELSON AVE",
            "address_2": "SUITE C",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953505341",
            "telephone_number": "209-846-9444",
            "fax_number": "209-844-0309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 NELSON AVE",
            "address_2": "SUITE C",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953505341",
            "telephone_number": "209-846-9444",
            "fax_number": "209-844-0309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OSLER MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2014-06-11",
        "status": "A",
        "authorized_official_last_name": "METCALFE",
        "authorized_official_first_name": "ELLIOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "209-846-9444",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A65690",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0089790",
            "state": "CA"
        }
    ],
    "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 Jun 11, 2014; 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.