Sherille Pedron Sevilla, DO
Individual provider Active NPI Family Medicine Physician · Concord, CA
NPI 1649566324 · NPPES record last updated Jan 7, 2015
Key facts
- NPI
- 1649566324
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 20A13228 (CA)
- Practice address
- 2700 Grant St
#200
Concord, CA 94520-2266 - Phone
- (925) 677-0500
- Fax
- (925) 677-0519
- NPI assigned
- Jun 22, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- John Muir Physician Network
Practice addresses (Care Compare)
1450 Treat Blvd
Suite 220a
Walnut Creek, CA 94597-2168
Phone (925) 296-9730
Hospital & facility affiliations
- John Muir Home Health Services
- One Health Home Care, Inc
- Aspire Home Health
- John Muir Medical Center - Walnut Creek Campus
- John Muir Medical Center - Concord Campus
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20141118000417 | CA | Practitioner - Family Practice | 3577785039 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A13228 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| John Muir Physician Network | Current |
Accepting new patients | |
| John Muir Health | Past | Accepting new patients | |
| John Muir Health | Past | Accepting new patients |
Locations
2400 Balfour Rd
Ste 120
Brentwood, CA 94513
Phone (925) 308-8112
2700 Grant St
Ste 200
Concord, CA 94520
Phone (925) 674-2609
380 Civic Dr
Ste 100
Pleasant Hill, CA 94523
Phone (925) 284-3840
1450 Treat Blvd
Ste 120B
Walnut Creek, CA 94597
Phone (925) 296-9720
1450 Treat Blvd
#300
Walnut Creek, CA 94597
Phone (925) 952-2828
1450 Treat Blvd
Ste 220A
Walnut Creek, CA 94597
Phone (925) 296-9730
Interoperability endpoints
- ssevilla33303@ehr.johnmuirhealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Family Medicine Physician | 207Q00000X | 20A13228 | CA | Yes |
Addresses
Primary practice location
2700 Grant St
#200
Concord, CA 94520-2266
Mailing address
Dept 34929
P.O. Box 39000
San Francisco, CA 94139-0001
Phone (925) 952-2828
Other providers in Concord, CA
- Alaysha Sessoms
- Rajni Anne Sethi
- Grace Seuser
- Tyler Jay Severin
- Miriam Sevilla Cervantes
- Jessica V Seward
- Ghazaleh Seyed Mahmoudi II
- Ellohe Alemayehu Seyoum
- Leyla Tatiana Sezen
- Jakeisha A Shabazz
All providers in Concord, CA · Family Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 7, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.