Individual provider Active NPI

Jill Tamsen McLeod, PA

  • Surgical Physician Assistant
  • Merced, CA
National Provider Identifier
1306031406
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
19439 Issued in CA
Practice address
388 E Yosemite Ave Ste 100
Merced, CA 95340-8219
Phone
(209) 722-7801
Fax
(209) 722-1572
NPI assigned
Sep 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 17692 CA
Physician Assistant 363A00000X 19439 CA
Surgical Physician Assistant 363AS0400X 19439 CA Primary

Addresses

Primary practice location

388 E Yosemite Ave Ste 100
Merced, CA 95340-8219

Mailing address

3349 G Street Suite C
Merced, CA 95340
Phone (209) 580-4638

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190826001303 CA Practitioner - Physician Assistant 7618198300 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
May accept Medicare assignment
Group practices
Provident Primary Care IncGroup PAC ID 8628350873, 10 clinicians

Practice addresses (Care Compare)

3349 G St
Suite C
Merced, CA 95340-0978
Phone (209) 580-4638

Hospital & facility affiliations

  • Mercy Medical Center Hospital, Merced, CA, CCN 050444

Merit-based Incentive Payment System (MIPS)

Final score
99.15 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Golden State Dermatology Associates, Inc. CurrentSince Sep 1, 2019 Accepting new patients

Locations

388 E Yosemite Ave
Ste 100
Merced, CA 95340
Phone (209) 383-3456

370 N Wiget Ln
Ste 250
Walnut Creek, CA 94598
Phone (925) 278-7592

355 Lennon Ln
Ste 255
Walnut Creek, CA 94598
Phone (925) 932-7704

Interoperability endpoints

  • Direct secure messaging: jillmcleod@mcpmedicalofc.directglo.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 1

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": "1189468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1306031406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3349 G STREET SUITE C",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "95340",
            "telephone_number": "209-580-4638",
            "fax_number": "209-384-3966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "388 E YOSEMITE AVE STE 100",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953408219",
            "telephone_number": "209-722-7801",
            "fax_number": "209-722-1572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLEOD",
        "first_name": "JILL",
        "middle_name": "TAMSEN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-11",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "17692",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "19439",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "19439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merced, CA

Sources for this page

Verify at the official NPI Registry.