Individual provider Active NPI

Jason Antunez, M.D.

  • Emergency Medicine Physician
  • Merced, CA
National Provider Identifier
1578852877
Registry record updated Apr 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A129413 Issued in CA
Practice address
333 Mercy Ave
Mercy Medical Center Emergency Department
Merced, CA 95340-8319
Phone
(209) 564-5000
NPI assigned
Apr 7, 2011
Last updated
Apr 9, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 293366 NY
Family Medicine Physician 207Q00000X 293366 NY
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X A129413 CA Primary

Addresses

Primary practice location

333 Mercy Ave
Mercy Medical Center Emergency Department
Merced, CA 95340-8319

Mailing address

1990 N California Blvd Ste 400
Walnut Creek, CA 94596-7249
Phone (925) 482-8240

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140925000443 CA Practitioner - Emergency Medicine 9739309741 Reassigns benefits to 1 organization
I20180424001707 NY Practitioner - Emergency MedicinePractitioner - Family Practice 9739309741 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
129413CAMDMental Health Counselor
A129413CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physician Services of New York, P.C. Emergency Medicine CurrentSince Apr 1, 2018 Accepting new patients
San Joaquin Emergency Medical Associates Emergency Medicine CurrentSince Jul 14, 2014 Accepting new patients
North Sonoma County Health Care District Past Accepting new patients

Locations

333 Mercy Ave
Merced, CA 95340
Phone (209) 385-1280

670 Stoneleigh Ave
Carmel, NY 10512
Phone (845) 230-4721

45 Reade Pl
Poughkeepsie, NY 12601
Phone (845) 331-3131

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1302134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523232000000",
    "number": "1578852877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1990 N CALIFORNIA BLVD STE 400",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945967249",
            "telephone_number": "925-482-8240",
            "fax_number": "925-482-8241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 MERCY AVE",
            "address_2": "MERCY MEDICAL CENTER EMERGENCY DEPARTMENT",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953408319",
            "telephone_number": "209-564-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTUNEZ",
        "first_name": "JASON",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-07",
        "last_updated": "2018-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "293366",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "293366",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A129413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merced, CA

Sources for this page

Verify at the official NPI Registry.