Individual provider Active NPI

Alfredo Negrete Jr., M.D.

  • Pediatric Adolescent Medicine Physician
  • El Centro, CA
National Provider Identifier
1972595957
Registry record updated Feb 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
A74018 Issued in CA
Practice address
702 Wake Ave
El Centro, CA 92243-7502
Phone
(760) 352-7216
Fax
(760) 352-1028
NPI assigned
Aug 17, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Legal Medicine 173000000X
Pediatric Adolescent Medicine Physician 2080A0000X A74018 CA Primary

Addresses

Primary practice location

702 Wake Ave
El Centro, CA 92243-7502

Mailing address

702 Wake Ave
El Centro, CA 92243-7502
Phone (760) 352-7216

Other identifiers 1

IdentifierTypeStateIssuer
A74018OtherCAMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A74018CAMDPediatric Adolescent Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Imperial County Pediatric Associates, Inc. PastSince Jun 23, 2025 Accepting new patients
Adolscents Babies & Childrens Pediatric Medical Group, Inc. Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1124236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677542400000",
    "number": "1972595957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 WAKE AVE",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922437502",
            "telephone_number": "760-352-7216",
            "fax_number": "760-352-1028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 WAKE AVE",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922437502",
            "telephone_number": "760-352-7216",
            "fax_number": "760-352-1028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEGRETE",
        "first_name": "ALFREDO",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-17",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "CA",
            "license": "A74018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "A74018",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Centro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2023; 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.