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PRIME PATH MEDICAL GROUP MD
NPI 1396625612
Emergency Medicine in Glendale, CA

Active since September 05, 2025
1500 S CENTRAL AVE STE 323, GLENDALE, CA 91204(747) 200-6948(747) 800-8005 Get Directions Write a Review

NPPES record last updated: September 5, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Prime Path Medical Group Md NPPES

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

PRIME PATH MEDICAL GROUP MD (NPI 1396625612) is a healthcare organization registered as an emergency medicine in Glendale, California and active in the NPI registry since September 2025. The organization lists Mason Alexander Bragg, Md, Co-owner, Predident, as its authorized official.

NPPES Registry Identity

NPI1396625612
Entity TypeOrganization
Primary Taxonomy207P00000X
Legal Business NamePRIME PATH MEDICAL GROUP MD
Location Address1500 S CENTRAL AVE STE 323Glendale, CA 91204-3858
Mailing Address1500 S Central Ave Ste 323Glendale, CA 91204-3858 · (747) 200-6948 · Fax (747) 800-8005
Phone(747) 200-6948
Fax(747) 800-8005
Organization SubpartNo
Authorized OfficialMason Alexander BraggMd, Co-owner, Predident · (747) 800-8005
Enumeration DateSeptember 5, 2025
NPPES CertifiedSeptember 5, 2025
✔ NPI 1396625612 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
1500 S CENTRAL AVE STE 323, Glendale, CA 91204
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Prime Path Medical Group MD, which bills Medicare for the services this clinician delivers.

Clinician (1)

Mason Bragg, MD, MPH
Emergency Medicine
NPI 1316162407
593 EDDY ST
Providence, RI 02903
(401) 444-8450
✔ PECOS✔ Accepts Medicare2,579 mi

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

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 Prime Path Medical Group MD's NPI number?

The NPI number for Prime Path Medical Group MD is 1396625612. It was assigned to this organization in the NPPES registry on September 5, 2025.

Where is Prime Path Medical Group MD located?

Prime Path Medical Group MD is located at 1500 S Central Ave Ste 323, Glendale, CA 91204. The listed phone number is (747) 200-6948.

What is Prime Path Medical Group MD's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Prime Path Medical Group MD enrolled in Medicare?

Yes. Prime Path Medical Group MD is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Prime Path Medical Group MD?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Emergency Medicine) reassigns their Medicare billing to Prime Path Medical Group MD. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Prime Path Medical Group MD was last updated on September 5, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.