Individual provider Active NPI

Stacy Marie Catalon, M.D.

  • Pediatrics Physician
  • Riverside, CA
National Provider Identifier
1023453081
Registry record updated Apr 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A134160 Issued in CA
Practice address
19314 Jesse LN
Riverside, CA 92508-5069
Phone
(951) 782-3640
Fax
(951) 776-4515
NPI assigned
May 5, 2013
Last updated
Apr 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2025

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 A134160 CA Primary

Addresses

Primary practice location

19314 Jesse LN
Riverside, CA 92508-5069

Mailing address

19314 Jesse LN
Riverside, CA 92508-5069
Phone (951) 782-3640

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
I20180315002443 CA Practitioner - Pediatric Medicine 8426310103 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A134160CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Medical Clinic, Inc Current Accepting new patients
Riverside Medical Clinic, Inc Pediatrics CurrentSince Feb 12, 2018 Accepting new patients
Riverside Medical Clinic, Inc Pediatrics CurrentSince Feb 12, 2018 Accepting new patients
Riverside Medical Clinic, Inc Pediatrics Past Accepting new patients
Riverside Medical Clinic, Inc Pediatrics Past Accepting new patients

Locations

19314 Jesse Ln
Riverside, CA 92508
Phone (951) 782-3640

19314 Jesse Ln
Ste 100
Riverside, CA 92508
Phone (951) 776-4503

3660 Arlington Ave
Riverside, CA 92506
Phone (951) 782-3789

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1367712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744329600000",
    "number": "1023453081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19314 JESSE LN",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925085069",
            "telephone_number": "951-782-3640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19314 JESSE LN",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925085069",
            "telephone_number": "951-782-3640",
            "fax_number": "951-776-4515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CATALON",
        "first_name": "STACY",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-05",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A134160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.