Individual provider Active NPI

John Prekezes, M.D.

  • Specialist
  • Rancho Mirage, CA
National Provider Identifier
1891911491
Registry record updated Feb 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A77463 Issued in CA
Practice address
40075 Bob Hope Dr
Suite F
Rancho Mirage, CA 92270-3942
Phone
(760) 770-5355
Fax
(760) 770-5372
NPI assigned
Apr 18, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A77463 CA Primary

Addresses

Primary practice location

40075 Bob Hope Dr
Suite F
Rancho Mirage, CA 92270-3942

Mailing address

40075 Bob Hope Dr
Suite F
Rancho Mirage, CA 92270-3942
Phone (760) 770-5355

Other identifiers 1

IdentifierTypeStateIssuer
00A774630OtherCAMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, WI2 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
I20031119000946 CA Practitioner - Internal Medicine 2961306287 Practice locations: Rancho Mirage, CA
I20151022002843 WI Practitioner - Internal Medicine 2961306287 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

40075 Bob Hope Dr
F
Rancho Mirage, CA 92270-3942
Phone (760) 770-5355

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dean Health Systems, Inc CurrentSince Oct 12, 2015 Accepting new patients
Dean Health Systems, Inc. CurrentSince Oct 12, 2015 Accepting new patients
Advocate North Side Health Network Past Accepting new patients
Kathryn Guggenheim MD Inc Specialist Past Accepting new patients

Locations

3400 E Racine St
Janesville, WI 53546
Phone (608) 373-8000

1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

Organizations & group practices 4

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 5

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": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361923200000",
    "number": "1891911491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40075 BOB HOPE DR",
            "address_2": "SUITE F",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922703942",
            "telephone_number": "760-770-5355",
            "fax_number": "760-770-5372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40075 BOB HOPE DR",
            "address_2": "SUITE F",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922703942",
            "telephone_number": "760-770-5355",
            "fax_number": "760-770-5372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREKEZES",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2013-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A77463",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "00A774630",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Mirage, CA

Sources for this page

Verify at the official NPI Registry.