Jeanette Aviles, MD
Individual provider Active NPI Internal Medicine Physician · Redwood City, CA
NPI 1184772576 · NPPES record last updated Jan 6, 2011
Key facts
- NPI
- 1184772576
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- A55206 (CA)
- Practice address
- 2710 Middlefield Rd
Redwood City, CA 94063-3404 - Phone
- (650) 573-2222
- Fax
- (650) 298-6881
- NPI assigned
- Jan 8, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 18
Hospital & facility affiliations 10
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- University of California, San Francisco School of Medicine, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- County of San Mateo
Practice addresses (Care Compare)
222 W 39TH Ave
San Mateo, CA 94403-4364
Phone (650) 573-2222
Hospital & facility affiliations
- San Mateo Medical Center
- Peninsula Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100721000443 | CA | Practitioner - Internal Medicine | 0143352567 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A55206 | CA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of San Mateo | Current | Accepting new patients | |
| County of San Mateo | Current | Accepting new patients | |
| County of San Mateo | Current |
Accepting new patients | |
| County of San Mateo | Current | Accepting new patients | |
| County of San Mateo | Current |
Accepting new patients | |
| County of San Mateo | Current |
Accepting new patients | |
| County of San Mateo | Current | Accepting new patients |
Locations
380 90th St
Daly City, CA 94015
Phone (650) 301-8600
2710 Middlefield Rd
Redwood City, CA 94063
Phone (650) 364-6010
222 W 39th Ave
San Mateo, CA 94403
Phone (415) 573-2222
306 Spruce Ave
South San Francisco, CA 94080
Phone (650) 589-9305
Interoperability endpoints
- javiles18665@smch.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | A55206 | CA | Yes |
Addresses
Primary practice location
2710 Middlefield Rd
Redwood City, CA 94063-3404
Mailing address
2710 Middlefield Rd
Redwood City, CA 94063-3404
Phone (650) 578-7188
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A552060 | Medicaid | CA |
Other providers in Redwood City, CA
- Avalon Home Health Inc.
- Diana Avalos
- Alexander Avanesov
- Cindia Avelar
- Vivian Avila
- Anna Avina Gutierrez
- Awender Chiropractic Inc
- Joseph Ernest Awender II
- Luis Alberto Ayala
- Michael Ayala
All providers in Redwood City, CA · Internal Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 6, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.