Kevin P Carnevale Jr., M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

A140393 Issued in CA

Practice address

1364 N Waterman Ave
San Bernardino, CA 92404-5313

Phone

(909) 361-3061

Fax

(909) 677-2113

NPI assigned

Apr 16, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Obstetrics/Gynecology

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rancho Family Medical Group IncGroup PAC ID 6305741240, 112 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: kcarnevale72619@direct.llu.edu

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.

• Rancho Family Medical Group, Inc.

  • Family Medicine Physician
  • Temecula, CA
  • NPI 1598791600

  Obstetrics & Gynecology

  Medicare reassignment Care Compare group NPD
• Obhg California, P.C.

  • Obstetrics & Gynecology Physician
  • Greenville, SC
  • NPI 1215258892

  CA

  Medicare reassignment NPD
• Kvara LLC

  • Obstetrics & Gynecology Physician
  • Murrieta, CA
  • NPI 1972334811
  NPD Authorized official
• Inland Empire Womans Center, Medical Associates

  • Obstetrics & Gynecology Physician
  • San Bernardino, CA
  • NPI 1295270254
  NPD (past)
• UC San Diego Health - Rancho Family Medical Group

  • Multi-Specialty Clinic/Center
  • Temecula, CA
  • NPI 1003385071
  NPD (past)

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

{
    "created_epoch": "1397606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600905600000",
    "number": "1609296722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 WESTERN AVE STE 204",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924111353",
            "telephone_number": "909-474-9952",
            "fax_number": "909-474-9951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1364 N WATERMAN AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924045313",
            "telephone_number": "909-361-3061",
            "fax_number": "909-677-2113"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 Western Ave Ste 204",
            "address_purpose": "LOCATION",
            "city": "San Bernardino",
            "state": "CA",
            "postal_code": "924111353",
            "country_code": "US",
            "telephone_number": "909-474-9952",
            "fax_number": "909-474-9951",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16465 Sierra Lakes Pkwy Ste 245",
            "address_purpose": "LOCATION",
            "city": "Fontana",
            "state": "CA",
            "postal_code": "923361267",
            "country_code": "US",
            "telephone_number": "909-350-3003",
            "fax_number": "909-565-4129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARNEVALE",
        "first_name": "KEVIN",
        "middle_name": "P",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-16",
        "last_updated": "2020-09-24",
        "certification_date": "2020-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A140393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Michael Carlin
• Leonardo Carlito, MPT
• Vanessa Carlos, LCSW
• Janely Elizabeth Carmona
• Savannah Desiree Carmona
• Sweneleya Teyotae Carolina, LPCC/AMFT
• Mary Joyce C. Carota, MA, MFT
• Amber Marie Carpenter, LCSW
• Melissa Deanna Carpenter
• Arial Carr-Boothe

• Obstetrics & Gynecology Physician in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Obstetrics & Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2020; 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.