Individual provider Active NPI

John D. Mesaros, MD

  • Psychiatry Physician
  • Berkeley, CA
National Provider Identifier
1669587580
Registry record updated May 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
G131019 Issued in CA
Practice address
2006 Dwight Way
#101
Berkeley, CA 94704-2633
Phone
(925) 448-2958
NPI assigned
Aug 20, 2006
Last updated
May 3, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X G131019 CA Primary

Addresses

Primary practice location

2006 Dwight Way
#101
Berkeley, CA 94704-2633

Mailing address

225 Coggins Dr
Apt 252
Pleasant Hill, CA 94523-4402
Phone (925) 448-2958

Other names 1

  • Dr. John Daniel Mesaros Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, CA2 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
I20041001001089 MI Practitioner - Psychiatry 2769451012 Reassigns benefits to 2 organizations
I20150121002468 CA Practitioner - Psychiatry 2769451012 Practice locations: Berkeley, CA

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Michigan State University College of Human Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Guidance CenterGroup PAC ID 8022171735, 25 clinicians

Practice addresses (Care Compare)

13101 Allen Rd
Southgate, MI 48195-2216
Phone (734) 785-7700

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G131019CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nicholas Rosenlicht MD Inc Current Accepting new patients
The Guidance Center CurrentSince Sep 1, 2019 Accepting new patients
Community Services Group, Inc. PastSince Oct 1, 2002 Accepting new patients
G & H Enterprises, LLC Past Accepting new patients
Dailey Life, Inc. Past Accepting new patients

Locations

13101 Allen Rd
Southgate, MI 48195
Phone (734) 785-7701

20600 Eureka Rd
Ste 800
Taylor, MI 48180
Phone (313) 608-5188

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588464000000",
    "number": "1669587580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 COGGINS DR",
            "address_2": "APT 252",
            "city": "PLEASANT HILL",
            "state": "CA",
            "postal_code": "945234402",
            "telephone_number": "925-448-2958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2006 DWIGHT WAY",
            "address_2": "#101",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947042633",
            "telephone_number": "925-448-2958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MESAROS",
        "first_name": "JOHN",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2020-05-03",
        "certification_date": "2020-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G131019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHN",
            "last_name": "MESAROS",
            "middle_name": "DANIEL",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.