Active NPI
Grand Avenue Emergency Physicians Medical Group Inc
- Emergency Medicine Physician
- Bakersfield, CA
National Provider Identifier
1962913632
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- Legal business name
- GRAND AVENUE EMERGENCY PHYSICIANS MEDICAL GROUP INC
- Practice address
- 2215 Truxtun Ave
Bakersfield, CA 93301-3602 - Phone
- (330) 493-4443
- NPI assigned
- Oct 20, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Steven P Maron, MD
- Title
- President
- Phone
- (925) 225-5837
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | Primary |
Addresses
Primary practice location
2215 Truxtun Ave
Bakersfield, CA 93301-3602
Mailing address
4535 Dressler Rd NW
Canton, OH 44718-2545
Phone (330) 493-4443
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180112002313 | CA | Part B Supplier - Clinic/Group Practice | 7315206653 |
Receives reassigned benefits from 190 practitioners Practice locations: Bakersfield, CA |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 190
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Emergency Medicine Physician
- Bakersfield, CA
- NPI 1881333656
CA, Emergency Medicine
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- South Lake Tahoe, CA
- NPI 1730169111
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- Emergency Medicine Physician
- Los Angeles, CA
- NPI 1295788016
CA, Emergency Medicine
-
- Emergency Medicine Physician
- Lake Forest, IL
- NPI 1558821660
CA, Emergency Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1508457600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1624492800000",
"number": "1962913632",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4535 DRESSLER RD NW",
"city": "CANTON",
"state": "OH",
"postal_code": "447182545",
"telephone_number": "330-493-4443",
"fax_number": "330-493-8677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2215 TRUXTUN AVE",
"city": "BAKERSFIELD",
"state": "CA",
"postal_code": "933013602",
"telephone_number": "330-493-4443"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GRAND AVENUE EMERGENCY PHYSICIANS MEDICAL GROUP INC",
"organizational_subpart": "NO",
"enumeration_date": "2017-10-20",
"last_updated": "2021-06-24",
"certification_date": "2021-06-24",
"status": "A",
"authorized_official_last_name": "MARON",
"authorized_official_first_name": "STEVEN",
"authorized_official_middle_name": "P",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "925-225-5837",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Emergency Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bakersfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2021; 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.