Individual provider Active NPI

Neelu Kohli, M.D.

  • Emergency Medicine Physician
  • Fontana, CA
National Provider Identifier
1366645616
Registry record updated Jan 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A87993 Issued in CA
Practice address
17264 Foothill Blvd
Suite a
Fontana, CA 92335-9050
Phone
(909) 823-0000
NPI assigned
Jun 6, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X A87993 CA
Emergency Medicine Physician 207P00000X A87993 CA Primary

Addresses

Primary practice location

17264 Foothill Blvd
Suite a
Fontana, CA 92335-9050

Mailing address

17264 Foothill Blvd
Suite a
Fontana, CA 92335-9050
Phone (909) 823-0000

Other names 1

  • Neelu Kohli Maurer Former name

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
I20090427000371 CA Practitioner - Emergency Medicine 5193715639 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - CaliforniaGroup PAC ID 6103739131, 1,278 clinicians

Practice addresses (Care Compare)

27300 Iris Ave
Moreno Valley, CA 92555-4802
Phone (651) 243-0811

Hospital & facility affiliations

  • Kaiser Foundation Hospital-Moreno Valley Hospital, Moreno Valley, CA, CCN 050765

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
87993CAMDPharmacist
A87993CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California Emergency Medicine CurrentSince Sep 1, 2015 Accepting new patients
Cep America-California Emergency Medicine CurrentSince Sep 1, 2015 Accepting new patients
Cep America - California Emergency Medicine Current Accepting new patients
San Francisco Physicians International Medical Group, Inc Emergency Medicine Past Accepting new patients
Salem Health West Valley Past Accepting new patients

Locations

800 S Main St
Corona, CA 92882
Phone (909) 625-5411

500 W Hospital Rd
French Camp, CA 95231
Phone (209) 468-6000

27200 Calaroga Ave
Hayward, CA 94545
Phone (510) 264-2000

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

27300 Iris Ave
Moreno Valley, CA 92555
Phone (909) 243-0811

1150 N Indian Canyon Dr
Palm Springs, CA 92262
Phone (760) 323-6251

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

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 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": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580342400000",
    "number": "1366645616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17264 FOOTHILL BLVD",
            "address_2": "SUITE A",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923359050",
            "telephone_number": "909-823-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17264 FOOTHILL BLVD",
            "address_2": "SUITE A",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923359050",
            "telephone_number": "909-823-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOHLI",
        "first_name": "NEELU",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-06",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A87993",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A87993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NEELU",
            "last_name": "KOHLI MAURER",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fontana, CA

Sources for this page

Verify at the official NPI Registry.