Individual provider Active NPI

Rajashekar Reddy Yeruva, MD

  • Family Medicine Physician
  • Stockton, CA
National Provider Identifier
1174083588
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A183892 Issued in CA
Practice address
1801 E March LN Ste D470
Stockton, CA 95210-6677
Phone
(209) 507-7049
NPI assigned
Mar 21, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A183892 CA Primary

Addresses

Primary practice location

1801 E March LN Ste D470
Stockton, CA 95210-6677

Mailing address

1801 E March LN Ste D470
Stockton, CA 95210-6677
Phone (209) 507-7049

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
I20230915002403 CA Practitioner - Family PracticePractitioner - Geriatric Medicine 5890029318 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Medical Centers, Inc.Group PAC ID 8426968520, 47 clinicians

Practice addresses (Care Compare)

1150 S Cherokee LN
Lodi, CA 95240-5918
Phone (209) 370-1700

2401 W Turner Rd
Suite 450
Lodi, CA 95242-2191
Phone (209) 370-1700

701 E Channel St
Stockton, CA 95202-2628
Phone (209) 944-4700

721 Calaveras St
Lodi, CA 95240-0628
Phone (209) 331-8019

747 E Channel St
Stockton, CA 95202-2628
Phone (209) 940-4670

Hospital & facility affiliations

  • Adventist Health Lodi Memorial Hospital, Lodi, CA, CCN 050336
  • St Joseph'S Medical Center of Stockton Hospital, Stockton, CA, CCN 050084

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A183892CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Centers Inc CurrentSince Jul 19, 2023 Accepting new patients
Community Medical Centers, Inc. Current Accepting new patients
Community Medical Centers, Inc CurrentSince Jul 19, 2023 Accepting new patients

Locations

1150 S Cherokee Ln
Lodi, CA 95240
Phone (209) 370-1700

1801 E March Ln
Ste D470
Stockton, CA 95210
Phone (209) 507-7000

701 E Channel St
Stockton, CA 95202
Phone (209) 944-4700

7210 Murray Dr
Stockton, CA 95210
Phone (209) 373-2816

730 N Central Ave
Tracy, CA 95376
Phone (209) 820-1500

Interoperability endpoints

  • Direct secure messaging: ryeruva768738@direct.ochin.org
  • Direct secure messaging: rajashekar.yeruva.p1@direct.cmcentersinc.nextgenshare.com

Organizations & group practices 3

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 2

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": "1553126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1174083588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 E MARCH LN STE D470",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952106677",
            "telephone_number": "209-507-7049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 E MARCH LN STE D470",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952106677",
            "telephone_number": "209-507-7049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YERUVA",
        "first_name": "RAJASHEKAR REDDY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-21",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A183892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.