Individual provider Active NPI

Jeffery Alan Muller, M.D.

  • Family Medicine Physician
  • Corona, CA
National Provider Identifier
1003995754
Registry record updated Jul 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G5288 Issued in CA
Practice address
2815 S Main St Ste 210
Corona, CA 92882-2533
Phone
(951) 735-9211
Fax
(951) 735-6200
NPI assigned
Nov 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Preferred Provider Organization 305R00000X G52888 CA
Family Medicine Physician 207Q00000X G5288 CA Primary

Addresses

Primary practice location

2815 S Main St Ste 210
Corona, CA 92882-2533

Mailing address

341 Magnolia Ave Ste 201
Corona, CA 92879-3332
Phone (951) 735-9211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050603000555 CA Practitioner - Family Practice 3375598568 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
R Franklin University of Med & Sci/Chicago Medical School, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2815 S Main St
Suite 210
Corona, CA 92882-2533
Phone (951) 735-9211

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G5288CAMDFamily Medicine Physician
G52888CAMDPreferred Provider Organization

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Corona Extended Care, Inc.. Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: jeffery.muller.p51@direct.kmsm.nextgenshare.com

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": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594857600000",
    "number": "1003995754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "341 MAGNOLIA AVE STE 201",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928793332",
            "telephone_number": "951-735-9211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2815 S MAIN ST STE 210",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928822533",
            "telephone_number": "951-735-9211",
            "fax_number": "951-735-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLER",
        "first_name": "JEFFERY",
        "middle_name": "ALAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2020-07-16",
        "certification_date": "2020-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "CA",
            "license": "G52888",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G5288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

Verify at the official NPI Registry.