Active NPI
Midtown Primary Care Associates Medical Group, Inc.
- Family Medicine Physician
- Roseville, CA
National Provider Identifier
1972657393
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- G42424
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G42424240 | Medicaid | CA |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Family Medicine Physician
- Sacramento, CA
- NPI 1447283817
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.