Individual provider Active NPI

Mercedes Denise Corlew, PA

  • Physician Assistant
  • Temecula, CA
National Provider Identifier
1609142850
Registry record updated Sep 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA22217 Issued in CA
Practice address
31700 Temecula Pkwy
Temecula, CA 92592-5896
Phone
(951) 331-2200
NPI assigned
Mar 31, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA22217 CA Primary

Addresses

Primary practice location

31700 Temecula Pkwy
Temecula, CA 92592-5896

Mailing address

18610 Boulder Ave
Riverside, CA 92508-9711
Phone (951) 776-2351

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160418001500 CA Practitioner - Physician Assistant 9436457850 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alertive Healthcare Medical Group ApcGroup PAC ID 9335543974, 39 clinicians

Practice addresses (Care Compare)

4354 Latham St
Suite 100
Riverside, CA 92501-1777
Phone (951) 466-6628

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Improvement activities
40
Cost
84.29

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
22217CAMDGeneral Practice Dentistry
PA22217CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Alertive Healthcare Medical Group PC PastSince Jul 28, 2024 Accepting new patients

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1333152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473292800000",
    "number": "1609142850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18610 BOULDER AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925089711",
            "telephone_number": "951-776-2351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31700 TEMECULA PKWY",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925925896",
            "telephone_number": "951-331-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORLEW",
        "first_name": "MERCEDES",
        "middle_name": "DENISE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-31",
        "last_updated": "2016-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA22217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temecula, CA

Sources for this page

Verify at the official NPI Registry.