Individual provider Active NPI

Jason Rinaldo Mevi, MD

  • Internal Medicine Physician
  • Los Banos, CA
National Provider Identifier
1295800258
Registry record updated Jun 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G75345 Issued in CA
Practice address
245 H St
Suite 2
Los Banos, CA 93635-4111
Phone
(209) 826-3200
Fax
(209) 826-1354
NPI assigned
Nov 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G75345 CA Primary

Addresses

Primary practice location

245 H St
Suite 2
Los Banos, CA 93635-4111

Mailing address

245 H St
Suite 2
Los Banos, CA 93635-4111
Phone (209) 826-3200

Other identifiers 1

IdentifierTypeStateIssuer
00G753450MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G75345CAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370304000000",
    "number": "1295800258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 H ST",
            "address_2": "SUITE 2",
            "city": "LOS BANOS",
            "state": "CA",
            "postal_code": "936354111",
            "telephone_number": "209-826-3200",
            "fax_number": "209-826-1354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 H ST",
            "address_2": "SUITE 2",
            "city": "LOS BANOS",
            "state": "CA",
            "postal_code": "936354111",
            "telephone_number": "209-826-3200",
            "fax_number": "209-826-1354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEVI",
        "first_name": "JASON",
        "middle_name": "RINALDO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2013-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G75345",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G753450",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Banos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.