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LEGACY MD MEDICAL GROUP INC
NPI 1073210753
General Practice in El Centro, CA

Active since February 13, 2023CLIA Certified · 5 labs
1699 N IMPERIAL AVE, EL CENTRO, CA 92243(760) 550-1685(888) 631-5150 Get Directions Write a Review

NPPES record last updated: February 16, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 11, 2025, Jan 8, 2025, Feb 13, 2023 (3 updates tracked since 2023).

About Legacy Md Medical Group Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LEGACY MD MEDICAL GROUP INC (NPI 1073210753) is a healthcare organization registered as a general practice in El Centro, California and active in the NPI registry since February 2023. The organization holds 5 active CLIA laboratory certificates, maintains a secondary practice location in Calexico, and lists John M Strong, President, as its authorized official.

NPPES Registry Identity

NPI1073210753
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameLEGACY MD MEDICAL GROUP INC
Location Address1699 N IMPERIAL AVEEl Centro, CA 92243-1320
Mailing Address1699 N Imperial AveEl Centro, CA 92243-1320 · (760) 550-1685 · Fax (888) 631-5150
Phone(760) 550-1685
Fax(888) 631-5150
Organization SubpartNo
Authorized OfficialJohn M StrongPresident · (760) 550-1685
Enumeration DateFebruary 13, 2023
Last NPPES UpdateFebruary 16, 20263 updates tracked since enumeration
NPPES CertifiedFebruary 16, 2026
✔ NPI 1073210753 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
Also ListedBehavior AnalystTaxonomy 103K00000X
Also ListedClinic/Center · Physical TherapyTaxonomy 261QP2000X
Also ListedClinic/Center · Urgent CareTaxonomy 261QU0200X
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
1699 N IMPERIAL AVE, El Centro, CA 92243
Open in Google Maps ↗

Secondary Practice Location 1

Location 1222 E Cole Blvd Ste CCalexico, CA 92231-3211 · Phone (760) 550-1685

Other Identifiers 1

Other1043248719CA · Npi

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Legacy Md Medical Group Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

49

Medicare enrollment records show 49 clinicians reassign Medicare billing to Legacy MD Medical Group Inc, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 19 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 24

Nurse Practitioner14
Internal Medicine4
Cardiovascular Disease (Cardiology)3
Marriage and Family Therapist3
Anesthesiology2
Clinical Psychologist2
Family Practice2
Gastroenterology2
16 other specialties17

Nearest to this location (20)

See all 49
Venus Nguyen
Nurse Practitioner
NPI 1053705087
1699 N IMPERIAL AVE
El Centro, CA 92243
(760) 352-2551
✔ PECOSSame address
John Strong, M.D.
Family Practice
NPI 1043248719
1699 N IMPERIAL AVE
El Centro, CA 92243
(760) 352-2551
✔ PECOS✔ Accepts MedicareSame address
Melissa Saenz
Marriage and Family Therapist
NPI 1558149369
313 S WATERMAN AVE
El Centro, CA 92243
(442) 265-1525
✔ PECOS✔ Accepts Medicare1.2 mi
Sohaib Tariq, M.D.
Cardiovascular Disease (Cardiology)
NPI 1023391166
435 W ATEN RD STE 2
Imperial, CA 92251
(760) 879-8590
✔ PECOS✔ Accepts Medicare1.2 mi
Amanda Castro, FNP-C
Nurse Practitioner
NPI 1184575797
2402 IMPERIAL BUSINESS PARK DR # 101
Imperial, CA 92251
(760) 355-5248
✔ PECOS1.3 mi
Marlene Batista
Nurse Practitioner
NPI 1194409979
2417 MARSHALL AVE STE 1
Imperial, CA 92251
(760) 355-0161
✔ PECOS1.3 mi
Benjamin Reisin, MFC
Marriage and Family Therapist
NPI 1891952180
266 W PLAYA DEL CARMEN
Imperial, CA 92251
(760) 960-5205
✔ PECOS✔ Accepts Medicare1.5 mi
Bhuwan Sharma, M.D.
Internal Medicine
NPI 1528096534
191 W JENNIFER DR
Imperial, CA 92251
(858) 349-6446
✔ PECOS✔ Accepts Medicare1.5 mi
Saqib Razzaque, M.D
Hematology/Oncology
NPI 1437398591
1271 ROSS AVE
El Centro, CA 92243
(760) 355-3030
✔ PECOS✔ Accepts Medicare1.9 mi
Amy Bullock, LCSW
Clinical Social Worker
NPI 1871997692
1073 ROSS AVE STE C
El Centro, CA 92243
(760) 540-4335
✔ PECOS✔ Accepts Medicare1.9 mi
Nasrin Ansari, MR
Anesthesiology
NPI 1609960483
1415 ROSS AVE
El Centro, CA 92243
(760) 339-7100
✔ PECOS✔ Accepts Medicare1.9 mi
Javier Lopez, FNP
Nurse Practitioner
NPI 1770340515
1520 S IMPERIAL AVE
El Centro, CA 92243
(760) 352-2551
✔ PECOS2.0 mi
Christian Romero, FNP
Nurse Practitioner
NPI 1942806237
1590 S IMPERIAL AVE
El Centro, CA 92243
(760) 352-2551
✔ PECOS2.0 mi
Jhoana Tovar, FNP
Nurse Practitioner
NPI 1649868191
1590 S IMPERIAL AVE
El Centro, CA 92243
(760) 352-2551
✔ PECOS2.0 mi
Alexis Vazquez, NP
Nurse Practitioner
NPI 1093265811
1463 S 4TH ST
El Centro, CA 92243
(760) 594-9100
✔ PECOS2.2 mi
Lisa Rosa-Re, M.D.
Family Practice
NPI 1336244896
852 E DANENBERG DR
El Centro, CA 92243
(760) 352-2257
✔ PECOS2.9 mi
Josue Mejia Ramirez, NP
Nurse Practitioner
NPI 1932992369
239 E GILLETT ST
El Centro, CA 92243
(442) 231-9003
✔ PECOS3.3 mi
Pamela Simpson, CNM, MS
Certified Nurse Midwife (CNM)
NPI 1821599903
852 E DANENBERG DR
El Centro, CA 92243
(760) 344-9951
✔ PECOS3.4 mi
Jose Valencia, PT, DPT
Physical Therapist in Private Practice
NPI 1194453860
1398 SPERBER RD
El Centro, CA 92243
(760) 312-6464
✔ Accepts Medicare3.9 mi
Jaime Englea Larra, DO
Anesthesiology
NPI 1962663286
207 W LEGION RD
Brawley, CA 92227
(760) 351-3288
✔ PECOS✔ Accepts Medicare10 mi
See all 49 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA 5

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2299476

Legacy MD Medical Group Inc · El Centro, CA
Active · expires Feb 20, 2028
CLIA Number05D2299476
Laboratory TypePhysician Office
Certificate Effective DateFebruary 21, 2026
Certificate Expiration DateFebruary 20, 2028
Laboratory DirectorJohn M. Strong
Laboratory Phone(760) 550-1685
Laboratory LocationLegacy MD Medical Group Inc1699 North Imperial Avenue, El Centro, CA 92243
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 05D2297310

Legacy MD Medical Group Inc · Calexico, CA
Active · expires Jan 11, 2028
CLIA Number05D2297310
Laboratory TypePhysician Office
Certificate Effective DateJanuary 12, 2026
Certificate Expiration DateJanuary 11, 2028
Laboratory DirectorJohn M. Strong
Laboratory Phone(760) 550-1685
Laboratory LocationLegacy MD Medical Group Inc222 East Cole Blvd, Suite C, Calexico, CA 92231
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Compliance 05D2078669

Legacy MD Medical Group Inc · Calexico, CA
Active · expires Jan 15, 2027
CLIA Number05D2078669
Laboratory TypePhysician Office
Certificate Effective DateJanuary 16, 2025
Certificate Expiration DateJanuary 15, 2027
Laboratory DirectorJohn M. Strong
Laboratory Phone(760) 550-1685
Laboratory LocationLegacy MD Medical Group Inc222 E Cole Blvd, Calexico, CA 92231
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Waiver 05D2299477

Legacy MD Medical Group Inc · Indio, CA
Active · expires Feb 20, 2028
CLIA Number05D2299477
Laboratory TypePhysician Office
Certificate Effective DateFebruary 21, 2026
Certificate Expiration DateFebruary 20, 2028
Laboratory DirectorTien T. Vo
Laboratory Phone(760) 550-1685
Laboratory LocationLegacy MD Medical Group Inc81812 Doctor Carreon Blvd, Suite E, Indio, CA 92201
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 05D2324667

Legacy MD Medical Group Inc · Brawley, CA
Active · expires May 28, 2027
CLIA Number05D2324667
Laboratory TypePhysician Office
Certificate Effective DateMay 29, 2025
Certificate Expiration DateMay 28, 2027
Laboratory DirectorJohn M. Strong
Laboratory Phone(760) 550-1685
Laboratory LocationLegacy MD Medical Group Inc290 Main St, Brawley, CA 92227
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Legacy MD Medical Group Inc's NPI number?

The NPI number for Legacy MD Medical Group Inc is 1073210753. It was assigned to this organization in the NPPES registry on February 13, 2023.

Where is Legacy MD Medical Group Inc located?

Legacy MD Medical Group Inc is located at 1699 N Imperial Ave, El Centro, CA 92243. The listed phone number is (760) 550-1685.

What is Legacy MD Medical Group Inc's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Legacy MD Medical Group Inc enrolled in Medicare?

Yes. Legacy MD Medical Group Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Legacy MD Medical Group Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 49 clinicians in 24 Medicare specialties reassign their Medicare billing to Legacy MD Medical Group Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (14), Internal Medicine (4) and Cardiovascular Disease (Cardiology) (3). Of these, 2 practice at this address and 19 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Legacy MD Medical Group Inc hold CLIA laboratory certificates?

Yes. 5 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Legacy MD Medical Group Inc accept?

Health plans from Anthem Blue Cross and Blue Shield list Legacy MD Medical Group Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Legacy MD Medical Group Inc was last updated on February 16, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.