Individual provider Active NPI

Davina Elvina Lopes de Menezes

  • Pediatrics Physician
  • Stockton, CA
National Provider Identifier
1013200278
Registry record updated Aug 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A130581 Issued in CA
Practice address
7210 Murray Dr
Stockton, CA 95210-3339
Phone
(209) 373-2859
Fax
(209) 373-2873
NPI assigned
May 20, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A130581 CA Primary

Addresses

Primary practice location

7210 Murray Dr
Stockton, CA 95210-3339

Mailing address

1115 Bayswater Ave
Burlingame, CA 94010-4304
Phone (650) 358-8684

Other names 1

  • Davina Elvina Lopes de Meneses Former name

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
I20141105002657 CA Practitioner - Pediatric Medicine 9133341209 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A130581CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Mateo CurrentSince Sep 20, 2016 Accepting new patients
County of San Mateo CurrentSince Sep 20, 2016 Accepting new patients
County of San Mateo CurrentSince Sep 20, 2016 Accepting new patients
Community Medical Centers Inc CurrentSince Oct 1, 2014 Accepting new patients
County of San Mateo CurrentSince Sep 20, 2016 Accepting new patients
County of San Mateo Current Accepting new patients
Community Medical Centers, Inc. Current Accepting new patients
Community Medical Centers, Inc CurrentSince Oct 1, 2014 Accepting new patients

Locations

222 W 39th Ave
San Mateo, CA 94403
Phone (415) 573-2222

306 Spruce Ave
South San Francisco, CA 94080
Phone (650) 589-9305

7210 Murray Dr
Stockton, CA 95210
Phone (209) 373-2816

730 N Central Ave
Tracy, CA 95376
Phone (209) 820-1500

Interoperability endpoints

  • Direct secure messaging: dlopesdemenezes768330@direct.ochin.org
  • FHIR API: https://api.platform.athenahealth.com/13302/brand/1/csg/1/fhir/r4
  • Direct secure messaging: davina.lopesdemenezes.p1@direct.cmcentersinc.nextgenshare.com
  • Direct secure messaging: dmenezes21643@smch.direct-ci.com

Organizations & group practices 8

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": "1305849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408924800000",
    "number": "1013200278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 BAYSWATER AVE",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940104304",
            "telephone_number": "650-358-8684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7210 MURRAY DR",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952103339",
            "telephone_number": "209-373-2859",
            "fax_number": "209-373-2873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPES DE MENEZES",
        "first_name": "DAVINA",
        "middle_name": "ELVINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-20",
        "last_updated": "2014-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A130581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAVINA",
            "last_name": "LOPES DE MENESES",
            "middle_name": "ELVINA",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.