Jonathan William Blevins, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

A117764 Issued in CA

Practice address

39000 Bob Hope Dr Dept of
Rancho Mirage, CA 92270-3221

Phone

(949) 263-8620

Fax

(800) 409-7005

NPI assigned

May 20, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Specialty

Diagnostic Radiology

Education

Georgetown University School of Medicine, 2006

Medicare assignment

May accept Medicare assignment

Group practices

Halo Medical GroupGroup PAC ID 7012806052, 20 clinicians

Desert Advanced Imaging Medical CenterGroup PAC ID 6406749613, 209 clinicians

Spectrum Imaging SCGroup PAC ID 3678892247, 41 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 38)

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.

• Desert Advanced Imaging Medical Center

  • Diagnostic Radiology Physician
  • Palm Desert, CA
  • NPI 1568416147
  Medicare reassignment Care Compare group NPD
• Halo Medical Group

  dba Desert Medical Imaging

  • Diagnostic Radiology Physician
  • Indian Wells, CA
  • NPI 1467506451
  Medicare reassignment Care Compare group NPD
• Spectrum Imaging SC

  • Radiology Clinic/Center
  • Chicago, IL
  • NPI 1821482621

  CA

  Medicare reassignment Care Compare group NPD
• Beverly Radiology Medical Group III

  • Diagnostic Radiology Physician
  • Los Angeles, CA
  • NPI 1962457812
  Medicare reassignment NPD
• Diagnostic Radiological Imaging

  • Diagnostic Radiology Physician
  • Sacramento, CA
  • NPI 1710931910
  Medicare reassignment NPD
• Fresno Imaging Center

  • Diagnostic Radiology Physician
  • Fresno, CA
  • NPI 1659456499
  Medicare reassignment NPD
• I V Radiology Medical Group

  • Diagnostic Radiology Physician
  • Brawley, CA
  • NPI 1235296880
  Medicare reassignment NPD
• Modesto Advanced Diagnostic Imaging Medical Center

  dba Modesto Advanced Diag Imaging Medical Center

  • Diagnostic Radiology Physician
  • Modesto, CA
  • NPI 1730133893
  Medicare reassignment NPD
• Norcal Imaging

  • Diagnostic Radiology Physician
  • Concord, CA
  • NPI 1003965997
  Medicare reassignment NPD
• Palms Imaging Medical Group

  • Diagnostic Radiology Physician
  • Oxnard, CA
  • NPI 1851347272
  Medicare reassignment NPD
• Santa Rosa Imaging Medical Center

  • Diagnostic Radiology Physician
  • Santa Rosa, CA
  • NPI 1689890444
  Medicare reassignment NPD
• Stockton Diagnostic Imaging

  • Diagnostic Radiology Physician
  • Stockton, CA
  • NPI 1356538201
  Medicare reassignment NPD

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

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499558400000",
    "number": "1477710127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18977",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895110550",
            "telephone_number": "949-263-8620",
            "fax_number": "800-409-7005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39000 BOB HOPE DR DEPT OF",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922703221",
            "telephone_number": "949-263-8620",
            "fax_number": "800-409-7005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLEVINS",
        "first_name": "JONATHAN",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-20",
        "last_updated": "2017-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MT189054",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A117764",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1477710127",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF CA",
            "identifier": "00A1177640",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lawrence Burnett Blackmon, D.D.S.
• Kenneth Blake, H.I.S.
• Burton Charles Blaurock, O.D.
• BLC Mirage Inn, L.P. (Brookdale Mirage Inn)
• Beverly Belle Blessing, FNP, PHD
• Block Counseling, Family & Child Therapy Inc.
• Blood & Cancer Genetics Institute
• Randy Bloom, FNP-BC
• Richard Stevan Bloom, ASW
• Kimberly Ann Bluff, FNP

• Diagnostic Radiology Physician in Rancho Mirage, CA
• Providers in Rancho Mirage, CA by specialty
• Diagnostic Radiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.