NPIMap

Individual provider Active NPI

John Paul Youssry Kelada, MD

  • Family Medicine Physician
  • Roseville, CA
National Provider Identifier
1013396118
Registry record updated Apr 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A145789 Issued in CA
Practice address
680 Sunrise Ave
Roseville, CA 95661
Phone
(916) 786-4700
Fax
(916) 786-3912
NPI assigned
May 21, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A145789 CA
Family Medicine Physician 207Q00000X A145789 CA Primary

Addresses

Primary practice location

680 Sunrise Ave
Roseville, CA 95661

Mailing address

680 Sunrise Ave
Roseville, CA 95661-4110
Phone (916) 786-4700

Other practice location 1

3291 Loma Vista Rd
Ventura, CA 93003-3099
Phone (805) 652-6100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171018002737 CA Practitioner - Family Practice 9830465822 Reassigns benefits to 2 organizations
Practice locations: Roseville, CA

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Vermont College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kelada Physicians Group IncGroup PAC ID 9638401144, 3 clinicians

Practice addresses (Care Compare)

680 Sunrise Ave
Roseville, CA 95661-4110
Phone (916) 786-4700

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A145789CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Medical Foundation CurrentSince Mar 30, 2020 Accepting new patients
Kelada Physicians Group, Inc CurrentSince Oct 1, 2019 Accepting new patients
Dignity Health Medical Foundation CurrentSince Mar 30, 2020 Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
Dignity Health Past Accepting new patients
Hill Physicians Medical Group - PPO Program Past Accepting new patients
Dignity Health Past Accepting new patients
Dignity Health Past Accepting new patients
Dignity Health Medical Foundation Past Accepting new patients

Locations

6501 Coyle Ave
Carmichael, CA 95608
Phone (916) 537-5000

6555 Coyle Ave
Ste 280
Carmichael, CA 95608
Phone (916) 536-3540

680 Sunrise Ave
Roseville, CA 95661
Phone (916) 521-6419

8120 Timberlake Way
Ste 107
Sacramento, CA 95823
Phone (916) 681-6000

3000 Q St
Fl 3
Sacramento, CA 95816
Phone (916) 733-3400

Interoperability endpoints

  • Direct secure messaging: jkelada43733@hpmg.direct-ci.net

Organizations & group practices 9

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1432166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554940800000",
    "number": "1013396118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 SUNRISE AVE",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614110",
            "telephone_number": "916-786-4700",
            "fax_number": "916-786-3912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 SUNRISE AVE",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "95661",
            "telephone_number": "916-786-4700",
            "fax_number": "916-786-3912"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3291 Loma Vista Rd",
            "address_purpose": "LOCATION",
            "city": "Ventura",
            "state": "CA",
            "postal_code": "930033099",
            "country_code": "US",
            "telephone_number": "805-652-6100",
            "fax_number": "805-652-3252",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELADA",
        "first_name": "JOHN PAUL",
        "middle_name": "YOUSSRY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-21",
        "last_updated": "2019-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A145789",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A145789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.