NPIMap

Organization Active NPI

North Bay Neurologic Medical Associates, Inc.

  • Neurology Physician
  • Greenbrae, CA
National Provider Identifier
1609056233
Registry record updated Apr 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
G403210 Issued in CA
Legal business name
NORTH BAY NEUROLOGIC MEDICAL ASSOCIATES, INC.
Practice address
1000 S Eliseo Dr Ste 204
Greenbrae, CA 94904-2151
Phone
(415) 464-0411
NPI assigned
Nov 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2008

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

Authorized official

Name
John Richard Mendius, MDNPI 1295765881
Title
Owner
Phone
(415) 464-0411

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X G403210 CA Primary

Addresses

Primary practice location

1000 S Eliseo Dr Ste 204
Greenbrae, CA 94904-2151

Mailing address

1000 S Eliseo Dr Ste 204
Greenbrae, CA 94904-2151
Phone (415) 464-0411

Other identifiers 3

IdentifierTypeStateIssuer
1235230384OtherCANPI
1295765881OtherCANPI
00G403210MedicaidCA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1194825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207267200000",
    "number": "1609056233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 S ELISEO DR STE 204",
            "city": "GREENBRAE",
            "state": "CA",
            "postal_code": "949042151",
            "telephone_number": "415-464-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 S ELISEO DR STE 204",
            "city": "GREENBRAE",
            "state": "CA",
            "postal_code": "949042151",
            "telephone_number": "415-464-0411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH BAY NEUROLOGIC MEDICAL ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-12",
        "last_updated": "2008-04-04",
        "status": "A",
        "authorized_official_last_name": "MENDIUS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "415-464-0411",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "G403210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1235230384",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1295765881",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G403210",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenbrae, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2008; 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.