NPIMap

Organization Active NPI

Nelson R. Maldonadom.D.,Inc.

  • Surgery Physician
  • Grass Valley, CA
National Provider Identifier
1508085499
Registry record updated Apr 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
208600000X Issued in CA
Legal business name
NELSON R. MALDONADOM.D.,INC.
Practice address
150 Catherine LN
Suite G
Grass Valley, CA 95945-5719
Phone
(530) 477-0931
Fax
(530) 477-0934
NPI assigned
Apr 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2012

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

Authorized official

Name
Nelson R. Maldonado, M.D.
Title
President
Phone
(530) 477-0931

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 208600000X CA Primary

Addresses

Primary practice location

150 Catherine LN
Suite G
Grass Valley, CA 95945-5719

Mailing address

PO Box 2618
Grass Valley, CA 95945-2618
Phone (530) 477-0931

Other identifiers 2

IdentifierTypeStateIssuer
G53915OtherCALICENCE
00G539150MedicaidCA

National Provider Directory

National Provider Directory

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334188800000",
    "number": "1508085499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2618",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959452618",
            "telephone_number": "530-477-0931",
            "fax_number": "530-477-0934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 CATHERINE LN",
            "address_2": "SUITE G",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959455719",
            "telephone_number": "530-477-0931",
            "fax_number": "530-477-0934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NELSON R. MALDONADOM.D.,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-25",
        "last_updated": "2012-04-12",
        "status": "A",
        "authorized_official_last_name": "MALDONADO",
        "authorized_official_first_name": "NELSON",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "530-477-0931",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "CA",
            "license": "208600000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENCE",
            "identifier": "G53915",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G539150",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grass Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2012; 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.