NPIMap

Organization Active NPI

Solano Gateway Medical Group Inc

  • Emergency Medicine Physician
  • Fairfield, CA
National Provider Identifier
1952344293
Registry record updated Sep 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
SOLANO GATEWAY MEDICAL GROUP INC
Practice address
1200 B Gale Wilson Blvd
Fairfield, CA 94533-3552
Phone
(925) 924-1600
NPI assigned
Jun 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2025

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

Authorized official

Name
Dr. Neil Mendelson, M.D.
Title
Ceo / Cfo
Phone
(865) 693-1000

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207P00000X Primary
Physician AssistantGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

1200 B Gale Wilson Blvd
Fairfield, CA 94533-3552

Mailing address

PO Box 635198
Cincinnati, OH 45263-5198

Other practice location 1

225 N Jackson Ave
San Jose, CA 95116-1603
Phone (408) 259-5000

Other identifiers 3

IdentifierTypeStateIssuer
DC3984OtherCAMEDICARE RR
ZZZ05562ZOtherCABS CALIFORNIA
GR0092091MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040916001355 CA Part B Supplier - Clinic/Group Practice 5496725418 Receives reassigned benefits from 281 practitioners
Practice locations: San Jose, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 309

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 309

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758153600000",
    "number": "1952344293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635198",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452635198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 B GALE WILSON BLVD",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945333552",
            "telephone_number": "925-924-1600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "225 N JACKSON AVE",
            "address_purpose": "LOCATION",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951161603",
            "country_code": "US",
            "telephone_number": "408-259-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOLANO GATEWAY MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2025-09-18",
        "certification_date": "2025-09-18",
        "status": "A",
        "authorized_official_last_name": "MENDELSON",
        "authorized_official_first_name": "NEIL",
        "authorized_official_title_or_position": "CEO / CFO",
        "authorized_official_telephone_number": "865-693-1000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "DC3984",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS CALIFORNIA",
            "identifier": "ZZZ05562Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0092091",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.