Active NPI
Raquel M. Medeiros, PA-C
- Medical Physician Assistant
- Desert Hot Springs, CA
National Provider Identifier
1023143633
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA13326
- Practice address
- 12560 Palm Dr
Desert Hot Springs, CA 92240-4559 - Phone
- (760) 251-3401
- Fax
- (760) 251-9592
- NPI assigned
- Feb 22, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA13326 | CA | Primary |
Addresses
Primary practice location
12560 Palm Dr
Desert Hot Springs, CA 92240-4559
Mailing address
255 N El Cielo Rd
Suite # 604
Palm Springs, CA 92262-6974
Phone (760) 251-3401
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: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA13326 | CA | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Western Horizon Medical Group | Past | Accepting new patients |
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- raquel.medeiros.p2@direct.mydohc.nextgenshare.com
- raquel.medeiros.p73@direct.mydohc.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Desert Oasis Healthcare Medical Group
- Family Medicine Physician
- Palm Springs, CA
- NPI 1114918612
-
- Health Service Clinic/Center
- Rancho Mirage, CA
- NPI 1801925367
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1023143633",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "255 N EL CIELO RD",
"address_2": "SUITE # 604",
"city": "PALM SPRINGS",
"state": "CA",
"postal_code": "922626974",
"telephone_number": "760-251-3401",
"fax_number": "760-251-9592"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12560 PALM DR",
"city": "DESERT HOT SPRINGS",
"state": "CA",
"postal_code": "922404559",
"telephone_number": "760-251-3401",
"fax_number": "760-251-9592"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDEIROS",
"first_name": "RAQUEL",
"middle_name": "M.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CA",
"license": "PA13326",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Desert Hot Springs, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.