Individual provider Active NPI

Jaaneali Mehdi, M.D.

  • Psychiatry Physician
  • Modesto, CA
National Provider Identifier
1104071885
Registry record updated Mar 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
C156559 Issued in CA
Practice address
1501 Claus Rd Ste F
Modesto, CA 95355-9711
Phone
(095) 576-3102
NPI assigned
Nov 23, 2008
Last updated
Mar 19, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X C156559 CA Primary

Addresses

Primary practice location

1501 Claus Rd Ste F
Modesto, CA 95355-9711

Mailing address

220 Standiford Ave Ste F
Modesto, CA 95350-1159
Phone (209) 579-5628

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, MI, CA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20160401001490 MD Practitioner - Psychiatry 2567619406 Reassigns benefits to 2 organizations
I20161208002175 MI Practitioner - Psychiatry 2567619406 Reassigns benefits to 2 organizations
I20200619001957 CA Practitioner - Psychiatry 2567619406

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2008
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1501 Claus Rd F
Modesto, CA 95355-9711

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C156559CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sinai Hospital of Baltimore Inc Single Specialty Current Accepting new patients
Jaaneali Mehdi MD Inc Single Specialty CurrentSince Dec 30, 2016 Accepting new patients
Lakeland Hospitals at Niles and St Joseph, Inc Single Specialty CurrentSince Nov 8, 2017 Accepting new patients
Upmc Western Maryland Corporation CurrentSince Feb 21, 2016 Accepting new patients
Lakeland Hospitals at Niles and St Joseph, Inc CurrentSince Nov 8, 2017 Accepting new patients
Upmc Western Maryland Corporation Single Specialty Current Accepting new patients
Sinai Hospital of Baltimore Inc Psychiatry CurrentSince Apr 4, 2016 Accepting new patients
Sinai Hospital of Baltimore, Inc. CurrentSince Apr 4, 2016 Accepting new patients
Upmc Western Maryland Corporation Single Specialty CurrentSince Feb 21, 2016 Accepting new patients
Lakeland Medical Practices Single Specialty CurrentSince Nov 5, 2016 Accepting new patients
Lakeland Medical Practices CurrentSince Nov 5, 2016 Accepting new patients
Upmc Western Maryland Health Services, LLC Single Specialty Past Accepting new patients

Locations

1501 Claus Rd
Ste F
Modesto, CA 95355
Phone (209) 557-6310

220 Standiford Ave
Ste F
Modesto, CA 95350
Phone (209) 589-1500

2401 W Belvedere Ave
Baltimore, MD 21215

12500 Willowbrook Rd
Cumberland, MD 21502
Phone (240) 964-1255

12502 Willowbrook Rd
Ste 380
Cumberland, MD 21502
Phone (240) 964-8585

5401 Old Court Rd
Randallstown, MD 21133
Phone (301) 337-2727

1234 Napier Ave
Saint Joseph, MI 49085
Phone (269) 982-4941

3950 Hollywood Rd
Ste 280
Saint Joseph, MI 49085
Phone (269) 408-0990

Interoperability endpoints

  • Direct secure messaging: jmehdi535701@hisp.ehr.sutterhealth.org

Organizations & group practices 12

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": "1227398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584576000000",
    "number": "1104071885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 STANDIFORD AVE STE F",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953501159",
            "telephone_number": "209-579-5628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 CLAUS RD STE F",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953559711",
            "telephone_number": "095-576-3102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHDI",
        "first_name": "JAANEALI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-23",
        "last_updated": "2020-03-19",
        "certification_date": "2020-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "C156559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.