Mederva Medical Corporation

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MEDERVA MEDICAL CORPORATION

Practice address

4212 Balfour Ave
Oakland, CA 94610-1750

Phone

(954) 654-2857

NPI assigned

Oct 18, 2024

Organization subpart

No

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

Authorized official

Name

Mohammed Kaleel, MD

Title

Owner

Phone

(954) 654-2857

Specialties & licenses 4

Addresses

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Matthew J Niedzwiecki, MD

  • Psychiatry Physician
  • Loma Linda, CA
  • NPI 1174859284
  NPD

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

{
    "created_epoch": "1729209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782432000000",
    "number": "1417778713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4212 BALFOUR AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946101750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4212 BALFOUR AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946101750",
            "telephone_number": "954-654-2857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDERVA MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-18",
        "last_updated": "2026-06-26",
        "certification_date": "2026-06-26",
        "status": "A",
        "authorized_official_last_name": "KALEEL",
        "authorized_official_first_name": "MOHAMMED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-654-2857",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "care@direct.mederva.com",
            "affiliation": "N",
            "endpointDescription": "Mederva care coordination and referrals",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Any",
            "address_1": "4212 Balfour Ave",
            "city": "Oakland",
            "state": "CA",
            "country_code": "US",
            "postal_code": "946101750",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Annmarie Mede
• Emily Jane Medeiros, PHARMD
• Monica Marie Medeiros
• Savannah A Medeiros
• Monica Medellin
• Medical Center Magnetic Imaging, LLC
• Medical Hill Rehab Center, LLC (Kindred Nursing and Rehabilitation-Medical Hill)
• Joksan Abdiel Medina Jarquin
• Amanda Medina
• Ana Medina, LCSW

• Family Medicine Physician in Oakland, CA
• Providers in Oakland, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2026; 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.