Joel Eidelson

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

A145569 Issued in CA

Practice address

582 E Harding Way
Stockton, CA 95204-6110

Phone

(209) 819-7178

Fax

(844) 226-9193

NPI assigned

Jul 21, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: joel.eidelson@2291.securemail.prognocis.com

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.

• Western Sierra Medical Clinic, Inc.

  • Urgent Care Clinic/Center
  • Downieville, CA
  • NPI 1851513469
  Medicare reassignment NPD
• Eidelson MD LLC

  • General Practice Physician
  • Elk Grove, CA
  • NPI 1245011907
  NPD Authorized official
• Western Sierra Medical Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • Grass Valley, CA
  • NPI 1063496396
  NPD
• Western Sierra Medical Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • Oregon House, CA
  • NPI 1780463257
  NPD
• Mark Twain Medical Center

  • Critical Access Hospital
  • San Andreas, CA
  • NPI 1508968819
  NPD (past)

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

{
    "created_epoch": "1405900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1457768566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "582 E HARDING WAY",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046110",
            "telephone_number": "209-819-7178",
            "fax_number": "844-226-9193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "582 E HARDING WAY",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046110",
            "telephone_number": "209-819-7178",
            "fax_number": "844-226-9193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EIDELSON",
        "first_name": "JOEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-21",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A145569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Egonio
• Ehlers Holdings Inc
• Matthew Ehlert
• David L Eibling, M.D.
• Johnpatrick Francis Eichler
• Toni Leona Eisenga
• Ashley E Eisfeld, BCBA
• Olalekan Monsuru Ejalonibu
• Iniobong Edem Ekong, R.N.
• Tsola Bassey Ekpokai

• General Practice Physician in Stockton, CA
• Providers in Stockton, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.