Active NPI
Neydi Salaverri Edmonds, PA-C
- Surgical Physician Assistant
- Fresno, CA
National Provider Identifier
1710058813
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 14622
- Practice address
- 2823 Fresno St
Fresno, CA 93721-1324 - Phone
- (559) 459-3770
- NPI assigned
- Nov 11, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 14622 | CA | |
| Surgical Physician Assistant | 363AS0400X | 14622 | CA | Primary |
Addresses
Primary practice location
2823 Fresno St
Fresno, CA 93721-1324
Mailing address
2625 E Divisadero St
Fresno, CA 93721-1431
Phone (559) 443-2682
Other names 1
- Neydi Salaverri Ellis
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| John C Fremont Healthcare District | Current | Accepting new patients | |
| John C Fremont Healthcare District | Current | Accepting new patients | |
| John C Fremont Healthcare District | Past | Accepting new patients | |
| John C. Fremont Healthcare District | Past | Accepting new patients |
Locations
5186 Hospital Rd
Mariposa, CA 95338
Phone (209) 966-0850
5189 Hospital Rd
Mariposa, CA 95338
Phone (209) 966-3631
Interoperability endpoints
- https://fhir-usa.unify.chbase.com/org/fremont-d0489e1b
Organizations & group practices 5
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.
-
- Rural Acute Care Hospital
- Mariposa, CA
- NPI 1750504270
-
- Family Medicine Physician
- Coulterville, CA
- NPI 1124248901
-
- Rural Acute Care Hospital
- Mariposa, CA
- NPI 1770706293
-
- Family Medicine Physician
- Mariposa, CA
- NPI 1134342652
-
- Family Medicine Physician
- Mariposa, CA
- NPI 1043433568
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163203200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579046400000",
"number": "1710058813",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2625 E DIVISADERO ST",
"city": "FRESNO",
"state": "CA",
"postal_code": "937211431",
"telephone_number": "559-443-2682",
"fax_number": "559-443-2681"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2823 FRESNO ST",
"city": "FRESNO",
"state": "CA",
"postal_code": "937211324",
"telephone_number": "559-459-3770"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SALAVERRI EDMONDS",
"first_name": "NEYDI",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-11",
"last_updated": "2020-01-15",
"certification_date": "2020-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "14622",
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "CA",
"license": "14622",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "NEYDI",
"last_name": "SALAVERRI ELLIS",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.