Individual provider Active NPI

Christopher J Meoli, DO

  • Diagnostic Radiology Physician
  • Rancho Mirage, CA
National Provider Identifier
1891731832
Registry record updated Feb 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
20A 10654 Issued in CA
Practice address
35800 Bob Hope Dr
Interventional Radiology and Imaging Center, Suite 150
Rancho Mirage, CA 92270-1739
Phone
(760) 770-1920
Fax
(760) 324-0848
NPI assigned
Jun 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 34435 MO
Vascular & Interventional Radiology Physician 2085R0204X 20A 10654 CA
Diagnostic Radiology Physician 2085R0202X 20A 10654 CA Primary

Addresses

Primary practice location

35800 Bob Hope Dr
Interventional Radiology and Imaging Center, Suite 150
Rancho Mirage, CA 92270-1739

Mailing address

35800 Bob Hope Dr
Interventional Radiology and Imaging Center, Suite 150
Rancho Mirage, CA 92270-1739
Phone (760) 770-1920

Other identifiers 5

IdentifierTypeStateIssuer
117809OtherMO BLUE
223318OtherHEALTHLINK
100016850BMedicaidOK
100230830BMedicaidKS
240912071MedicaidMO

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
I20090211000067 CA Practitioner - Diagnostic Radiology 0345330270 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34435MOMDDiagnostic Radiology Physician
20A 10654CAMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
San Fernando Valley Interventional Radiology and Imaging Center CurrentSince Sep 7, 2010 Accepting new patients
St Johns Regional Medical Center Past Accepting new patients
St Johns Regional Medical Center Past Accepting new patients
Sjmgroup Past Accepting new patients

Locations

16311 Ventura Blvd
Ste 120
Encino, CA 91436
Phone (818) 817-7707

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.

NPI Registry JSON

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423612800000",
    "number": "1891731832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35800 BOB HOPE DR",
            "address_2": "INTERVENTIONAL RADIOLOGY AND IMAGING CENTER, SUITE 150",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922701739",
            "telephone_number": "760-770-1920",
            "fax_number": "760-324-0848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35800 BOB HOPE DR",
            "address_2": "INTERVENTIONAL RADIOLOGY AND IMAGING CENTER, SUITE 150",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922701739",
            "telephone_number": "760-770-1920",
            "fax_number": "760-324-0848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEOLI",
        "first_name": "CHRISTOPHER",
        "middle_name": "J",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2015-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "34435",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "CA",
            "license": "20A 10654",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "20A 10654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MO BLUE",
            "identifier": "117809",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "223318",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100016850B",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100230830B",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "240912071",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Mirage, CA

Sources for this page

Verify at the official NPI Registry.