Individual provider Active NPI

Juan F O Meany, PA

  • Physician Assistant
  • Pittsburg, CA
National Provider Identifier
1922108273
Registry record updated Jan 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA14168 Issued in CA
Practice address
2240 Gladstone Dr
Ste #4
Pittsburg, CA 94565
Phone
(925) 431-1230
Fax
(925) 431-1234
NPI assigned
Sep 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA14168 CA Primary

Addresses

Primary practice location

2240 Gladstone Dr
Ste #4
Pittsburg, CA 94565

Mailing address

1601 Fruitvale Ave
Oakland, CA 94601-2418
Phone (510) 535-4000

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100330000984 CA Practitioner - Physician Assistant 8123154010 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA14168CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Centers Inc CurrentSince Jul 16, 2019 Accepting new patients
Community Medical Centers Inc CurrentSince Jul 16, 2019 Accepting new patients

Locations

7912 West Ln
Ste 221
Stockton, CA 95210
Phone (209) 546-3870

7210 Murray Dr
Stockton, CA 95210
Phone (209) 373-2816

730 N Central Ave
Tracy, CA 95376
Phone (209) 820-1500

Interoperability endpoints

  • Direct secure messaging: juan.omeany.p1@direct.cmcentersinc.nextgenshare.com
  • Direct secure messaging: jomeany768481@direct.ochin.org

Organizations & group practices 3

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": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326326400000",
    "number": "1922108273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 FRUITVALE AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946012418",
            "telephone_number": "510-535-4000",
            "fax_number": "510-535-4128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 GLADSTONE DR",
            "address_2": "STE #4",
            "city": "PITTSBURG",
            "state": "CA",
            "postal_code": "94565",
            "telephone_number": "925-431-1230",
            "fax_number": "925-431-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O MEANY",
        "first_name": "JUAN",
        "middle_name": "F",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2012-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA14168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburg, CA

Sources for this page

Verify at the official NPI Registry.