NPIMap

Individual provider Active NPI

Mervat G. Kelada, M.D.

  • Family Medicine Physician
  • Calexico, CA
National Provider Identifier
1255333035
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A48353 Issued in CA
Practice address
1001 Blair Ave
Calexico, CA 92231
Phone
(760) 768-5055
Fax
(760) 768-5037
NPI assigned
Aug 11, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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 A48353 CA Primary

Addresses

Primary practice location

1001 Blair Ave
Calexico, CA 92231

Mailing address

1001 Blair Ave
Calexico, CA 92231
Phone (760) 768-5055

Other identifiers 9

IdentifierTypeStateIssuer
032437OtherCAVFC IDENTIFIER
28248OtherAZARIZONA LICENSE NUMBER
A48353OtherCALICENSE NUMBER
RHM53866FMedicaidCA
13070OtherMIMISSISSIPPI LICENSE NUMBE
ME 62257OtherFLFLORIDA LICENSE NUMBER
00A483531OtherCAINSURANCE
330742343OtherCAE.I.N. NUMBER
05D0906507OtherCACLIA ID NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091013000444 CA Practitioner - Family Practice 5092890426 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1001 Blair Ave
Calexico, CA 92231-2308
Phone (760) 768-5055

207 E Barioni Blvd
Suite a
Imperial, CA 92251-1620
Phone (760) 355-2999

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mervat Kelada M.D. a Medical Corp Past Accepting new patients
Mervat Kelada M D a Medical Corporation Past Accepting new patients
El Centro Regional Medical Center Past Accepting new patients
Mervat G. Kelada, M.D. Family Medicine Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JCFIBA/Endpoint/JCFIBA

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1255333035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 BLAIR AVE",
            "city": "CALEXICO",
            "state": "CA",
            "postal_code": "92231",
            "telephone_number": "760-768-5055",
            "fax_number": "760-768-5037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 BLAIR AVE",
            "city": "CALEXICO",
            "state": "CA",
            "postal_code": "92231",
            "telephone_number": "760-768-5055",
            "fax_number": "760-768-5037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELADA",
        "first_name": "MERVAT",
        "middle_name": "G.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-11",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A48353",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VFC  IDENTIFIER",
            "identifier": "032437",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA LICENSE NUMBER",
            "identifier": "28248",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "A48353",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHM53866F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSISSIPPI LICENSE NUMBE",
            "identifier": "13070",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA LICENSE NUMBER",
            "identifier": "ME 62257",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INSURANCE",
            "identifier": "00A483531",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "E.I.N. NUMBER",
            "identifier": "330742343",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA  ID NUMBER",
            "identifier": "05D0906507",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Calexico, CA

Sources for this page

Verify at the official NPI Registry.