Kelly Mah, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

G065156 Issued in CA

Practice address

1205 E North St
Manteca, CA 95336-4932

Phone

(209) 612-9077

Fax

(209) 824-0754

NPI assigned

Aug 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Obstetrics/Gynecology

Education

Albert Einstein College of Medicine of Yeshiva University, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

DHP of California Medical Group IncGroup PAC ID 9234388745, 12 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Joseph's Medical Center of Stockton Hospital, Stockton, CA, CCN 050084

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• DHP of California Medical Group Inc

  • Obstetrics & Gynecology Physician
  • Stockton, CA
  • NPI 1679836084
  Medicare reassignment Care Compare group NPD
• P. Gill Obstetrics & Gynecology Medical Group, Inc.

  • Obstetrics & Gynecology Physician
  • Lodi, CA
  • NPI 1386636165
  Medicare reassignment NPD
• Kelly Mah, M.D.

  dba Manteca Obstetrics and Gynecology Medical Group

  • Obstetrics & Gynecology Physician
  • Manteca, CA
  • NPI 1477654341
  NPD (past) Authorized official
• Hill Physicians Medical Group - PPO Program

  • Preferred Provider Organization
  • San Ramon, CA
  • NPI 1679011035
  NPD (past)

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

• Port City Operating Company, LLC

  dba St. Joseph's Medical Center of Stockton

  • General Acute Care Hospital
  • Stockton, CA
  • NPI 1528190931
  Care Compare affiliation

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1053420489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 993",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953361139",
            "telephone_number": "209-612-9077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 E NORTH ST",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953364932",
            "telephone_number": "209-612-9077",
            "fax_number": "209-824-0754"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1191 E Yosemite Ave Ste C",
            "address_purpose": "LOCATION",
            "city": "Manteca",
            "state": "CA",
            "postal_code": "953365071",
            "country_code": "US",
            "telephone_number": "209-824-2202",
            "fax_number": "209-824-2205",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAH",
        "first_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2023-03-07",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "G065156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0045320",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE NUMBER",
            "identifier": "G065156",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Donnabelle Salud Madayag
• Patricia Madrid
• Araseli Isabel Magallanes
• Janneth Magana Gil
• Magnolia Valley Transportation
• Aksha Chandra Maharaj
• Veneeta K. Maharaj, PHARMD.
• Jesca Maimba, RN, BSN, MPH
• Jacqueline Maldonado
• Carrie Malekow, RN

• Obstetrics & Gynecology Physician in Manteca, CA
• Providers in Manteca, CA by specialty
• Obstetrics & Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.