Organization Active NPI

Midtown Primary Care Associates Medical Group, Inc.

  • Family Medicine Physician
  • Roseville, CA
National Provider Identifier
1972657393
Registry record updated Oct 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G42424 Issued in CA
Legal business name
MIDTOWN PRIMARY CARE ASSOCIATES MEDICAL GROUP, INC.
Practice address
970 Reserve Dr
Suite 149
Roseville, CA 95678-1376
Phone
(916) 290-8672
NPI assigned
Jan 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2013

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

Authorized official

Name
Ms. Pamela J McDonald
Title
Practice Administrator
Phone
(916) 290-8672

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X G42424 CA Primary

Addresses

Primary practice location

970 Reserve Dr
Suite 149
Roseville, CA 95678-1376

Mailing address

970 Reserve Dr
Suite 149
Roseville, CA 95678-1376
Phone (916) 290-8672

Other identifiers 1

IdentifierTypeStateIssuer
00G42424240MedicaidCA

National Provider Directory

National Provider Directory

Locations

970 Reserve Dr
Ste 149
Roseville, CA 95678
Phone (916) 290-8672

3701 J St
Ste 220
Sacramento, CA 95816
Phone (916) 290-8672

5240 Elvas Ave
Sacramento, CA 95819
Phone (916) 290-8672

Practitioners & affiliated clinicians

Practitioners 1

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": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382572800000",
    "number": "1972657393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "970 RESERVE DR",
            "address_2": "SUITE 149",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956781376",
            "telephone_number": "916-290-8672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "970 RESERVE DR",
            "address_2": "SUITE 149",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956781376",
            "telephone_number": "916-290-8672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDTOWN PRIMARY CARE ASSOCIATES MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2013-10-24",
        "status": "A",
        "authorized_official_last_name": "MCDONALD",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "916-290-8672",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G42424",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G42424240",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2013; 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.