Individual provider Active NPI

Jamshid T. Mistry, DO

  • Neurological Surgery Physician
  • Colton, CA
National Provider Identifier
1770897266
Registry record updated Apr 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
20A12854 Issued in CA
Practice address
400 N Pepper Ave
Dept. Surgery Mod# 3
Colton, CA 92324-1801
Phone
(909) 580-3353
Fax
(909) 580-1363
NPI assigned
Jul 27, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 20A12854 CA
Neurocritical Care Physician 2084A2900X 20A12854 CA
Neurological Surgery Physician 207T00000X 20A12854 CA Primary

Addresses

Primary practice location

400 N Pepper Ave
Dept. Surgery Mod# 3
Colton, CA 92324-1801

Mailing address

400 N Pepper Ave
Dept. Surgery
Colton, CA 92324-1801
Phone (909) 580-3353

Other practice location 1

4234 Riverwalk Pkwy Ste 230
Riverside, CA 92505-3312
Phone (951) 781-3672

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160414001925 CA Practitioner - NeurologyPractitioner - Critical Care (Intensivists)Practitioner - Emergency Medicine 0749588333 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
NeurologyAlso: Critical Care (Intensivists)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - CaliforniaGroup PAC ID 6103739131, 1,278 clinicians

Practice addresses (Care Compare)

400 N Pepper Ave
Colton, CA 92324-1801
Phone (909) 580-6150

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A12854CAMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California Emergency Medicine CurrentSince Feb 1, 2017 Accepting new patients
El-Bershawi Medical Corp CurrentSince Oct 1, 2020 Accepting new patients
Inpatient Specialists of California, PC CurrentSince Mar 1, 2020 Accepting new patients
Cep America - California Emergency Medicine Current Accepting new patients
Cep America-California Emergency Medicine CurrentSince Feb 1, 2017 Accepting new patients
Cedars-Sinai Medical Center CurrentSince Jul 1, 2017 Accepting new patients
Cedars-Sinai Medical Center CurrentSince Jul 1, 2017 Accepting new patients
Stanford Hospital and Clinics Past Accepting new patients
Lucile Salter Packard Children'S Hospital at Stanford Past Accepting new patients
Stanford Health Care Emergency Medicine Past Accepting new patients
Pacific Professional Surgical Group Inc Past Accepting new patients
St. Mary Medical Center Past Accepting new patients

Locations

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

2755 Herndon Ave
Clovis, CA 93611
Phone (559) 323-4000

400 N Pepper Ave
#3
Colton, CA 92324
Phone (909) 580-3353

400 N Pepper Ave
Colton, CA 92324
Phone (909) 580-1800

4 Hughes
Ste 100
Irvine, CA 92618
Phone (949) 679-6874

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

4234 Riverwalk Pkwy
Ste 230
Riverside, CA 92505
Phone (951) 373-5819

225 N Jackson Ave
San Jose, CA 95116
Phone (408) 347-4051

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

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

8700 Beverly Blvd
West Hollywood, CA 90048
Phone (310) 385-3291

Interoperability endpoints

  • Direct secure messaging: jamshidtehmton.mistrydo.p1@direct.pacificpulm.nextgenshare.com

Organizations & group practices 12

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 1

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": "1280188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681171200000",
    "number": "1770897266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N PEPPER AVE",
            "address_2": "DEPT. SURGERY",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241801",
            "telephone_number": "909-580-3353",
            "fax_number": "909-580-1363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N PEPPER AVE",
            "address_2": "DEPT. SURGERY MOD# 3",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241801",
            "telephone_number": "909-580-3353",
            "fax_number": "909-580-1363"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4234 Riverwalk Pkwy Ste 230",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925053312",
            "country_code": "US",
            "telephone_number": "951-781-3672",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MISTRY",
        "first_name": "JAMSHID",
        "middle_name": "T.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-27",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "20A12854",
            "primary": false
        },
        {
            "code": "2084A2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurocritical Care",
            "state": "CA",
            "license": "20A12854",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "20A12854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colton, CA

Sources for this page

Verify at the official NPI Registry.