Individual provider Active NPI

Mahesh Lellella, MD

  • Internal Medicine Physician
  • San Leandro, CA
National Provider Identifier
1669050498
Registry record updated Apr 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
188418 Issued in CA
Practice address
2500 Merced St
San Leandro, CA 94577-4201
Phone
(510) 454-3000
NPI assigned
Apr 1, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 188418 CA Primary

Addresses

Primary practice location

2500 Merced St
San Leandro, CA 94577-4201

Mailing address

5608 N Dublin Ranch Dr
Dublin, CA 94568-8801
Phone (405) 638-6513

Other practice location 1

39400 Paseo Padre Pkwy
Fremont, CA 94538-2310
Phone (510) 454-3000

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NC2 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
I20231226000093 CA Practitioner - Internal Medicine 3870943350 Reassigns benefits to 4 organizations
I20250326003174 NC Practitioner - Internal Medicine 3870943350 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

2500 Merced St
San Leandro, CA 94577-4201
Phone (510) 454-1000

Hospital & facility affiliations

  • Kaiser Foundation Hospital - San Leandro Hospital, San Leandro, CA, CCN 050777
  • Kaiser Foundation Hospital - Fremont Hospital, Fremont, CA, CCN 050512

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
188418CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network Inc CurrentSince Dec 3, 2024 Accepting new patients
Hospitalist Medicine Physicians of California, Inc Internal Medicine CurrentSince Mar 7, 2025 Accepting new patients
Carolinas Physicians Network Inc Internal Medicine CurrentSince Dec 3, 2024 Accepting new patients
Permanente Medical Group, Inc CurrentSince Mar 14, 2025 Accepting new patients
Inpatient Specialists of California, PC Internal Medicine CurrentSince Mar 14, 2025 Accepting new patients
Permanente Medical Group Inc Internal Medicine CurrentSince Mar 14, 2025 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Dec 2, 2023 Accepting new patients
Healthcare Partners Affiliates Medical Group Internal Medicine CurrentSince Dec 2, 2023 Accepting new patients
Memorial Medical Group Inc Past Accepting new patients

Locations (25 of 29)

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

18300 US Highway 18
Apple Valley, CA 92307
Phone (760) 424-2311

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

5957 W Ramsey St
Banning, CA 92220
Phone (951) 845-8864

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

2000 Mowry Ave
Fremont, CA 94538
Phone (510) 793-6653

39400 Paseo Padre Pkwy
Fremont, CA 94538
Phone (510) 248-3000

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

797 S Fair Oaks Ave
Pasadena, CA 91105
Phone (626) 535-2434

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

501 J St
Sacramento, CA 95814
Phone (916) 497-3000

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

2500 Merced St
San Leandro, CA 94577
Phone (510) 454-1000

13855 E 14th St
San Leandro, CA 94578
Phone (510) 357-6500

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700

2101 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 881-4305

1700 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 883-8611

1000 Greenley Rd
Sonora, CA 95370
Phone (209) 263-0803

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

525 W Acacia St
Stockton, CA 95203
Phone (209) 944-5410

Interoperability endpoints

  • Direct secure messaging: mlellella152618@direct.whhs.com
  • Direct secure messaging: mlellella2943629@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 10

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 2

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": "1617235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1669050498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5608 N DUBLIN RANCH DR",
            "city": "DUBLIN",
            "state": "CA",
            "postal_code": "945688801",
            "telephone_number": "405-638-6513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 MERCED ST",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774201",
            "telephone_number": "510-454-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "39400 Paseo Padre Pkwy",
            "address_purpose": "LOCATION",
            "city": "Fremont",
            "state": "CA",
            "postal_code": "945382310",
            "country_code": "US",
            "telephone_number": "510-454-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LELLELLA",
        "first_name": "MAHESH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-01",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "188418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2500 Merced St",
            "city": "San Leandro",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945774201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Leandro, CA

Sources for this page

Verify at the official NPI Registry.