NPIMap

Individual provider Active NPI

Jesus N Marcelo, MD

  • Internal Medicine Physician
  • Richland, WA
National Provider Identifier
1457331159
Registry record updated Feb 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD00039738 Issued in WA
Practice address
829 Goethals Dr
Richland, WA 99352-3529
Phone
(509) 547-2204
Fax
(509) 542-8836
NPI assigned
Jan 19, 2006
Last updated
Feb 13, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD00039738 WA Primary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X MD00039738 WA

Addresses

Primary practice location

829 Goethals Dr
Richland, WA 99352-3529

Mailing address

PO Box 1452
Pasco, WA 99301-1223
Phone (509) 547-2204

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20070827000011 WA Practitioner - Internal MedicinePractitioner - Psychiatry 3072522440 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Psychiatry
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tri-Cities Community HealthGroup PAC ID 4183517469, 25 clinicians

Practice addresses (Care Compare)

829 Goethals Dr
Richland, WA 99352-3529
Phone (509) 547-2204

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00039738WAMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-Cities Community Health Current Accepting new patients
Reliance Medical Clinics, PLLC Current Accepting new patients
Tri Cities Community Health Past Accepting new patients

Locations

721 S Auburn St
Kennewick, WA 99336
Phone (509) 586-1157

515 W Court St
Pasco, WA 99301
Phone (509) 545-3020

1446 Spaulding Ave
Ste 303
Richland, WA 99352
Phone (509) 420-5060

915 Goethals Dr
Richland, WA 99352
Phone (509) 946-3700

Interoperability endpoints

  • Direct secure messaging: jesus.marcelo.1@21034.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486944000000",
    "number": "1457331159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1452",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "993011223",
            "telephone_number": "509-547-2204",
            "fax_number": "509-542-8836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "829 GOETHALS DR",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993523529",
            "telephone_number": "509-547-2204",
            "fax_number": "509-542-8836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCELO",
        "first_name": "JESUS",
        "middle_name": "N",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2017-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00039738",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "WA",
            "license": "MD00039738",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richland, WA

Sources for this page

Verify at the official NPI Registry.