MEDREV (NPI# 1669037362) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669037362 |
| Entity Type | Organization |
| Organization Name | MEDREV |
| Practice Address |
558 Chelsea Way Corona CA 92879-5880 |
| Practice Telephone | 9517729355 |
| Mailing Telephone | 9517729355 |
| Enumeration Date | 2019-05-08 |
| Last Update Date | 2019-05-08 |
| Authorized Official Name | CHELSEA MARI (OWNER) |
| Authorized Official Telephone | 9517729355 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251T00000X | PACE Provider Organization | Agencies |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | MEDREVO, LLC | 1120 Youngs Road, Williamsville, New York 14221 |
| Street Address |
558 CHELSEA WAY |
| City | CORONA |
| State | CA |
| Zip Code | 92879-5880 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609475722 | Tahmea Henderson | Behavior Technician | 225 Rincon St. #219, Corona, CA 92879 | 2020-10-20 |
| 1669084828 | Kimberly O Harris | Behavioral Analyst | 225 E. Rincon St., Suite 219, Corona, CA 92879 | 2020-08-19 |
| 1962014381 | Mario Javier Herrera | Nurse Practitioner | 2130 High Pointe Dr, Apt 108, Corona, CA 92879 | 2020-08-18 |
| 1841659117 | Sleep & Cpap Center Inc | Clinical Medical Laboratory | 800 Magnolia Avenue, Suite 101, Corona, CA 92879 | 2016-02-16 |
| 1497151203 | Rafik Riad | Dentist | 817 Villa Montes Cir., Corona, CA 92879 | 2014-11-06 |
| 1326441551 | Ying Zhang Howe | Acupuncturist | 720 Magnolia Ave. #b3, Corona, CA 92879 | 2014-10-02 |
| 1164823233 | Piyush Sakhareliya | Pharmacist | 2230 Treemont Pl, Apt#207, Corona, CA 92879 | 2014-09-09 |
| 1053711739 | Brandice Medical Associates Inc | Clinical Medical Laboratory | 13575 Jasper Loop, Corona, CA 92879 | 2014-08-29 |
| 1982956058 | Nja Therapy Services, Inc. | Day Training, Developmentally Disabled Services | 1655 E 6th St Suite 204, Corona, CA 92879 | 2012-10-12 |
| 1356616064 | Corona Surgical LLC | Clinic/Center | 2370 Anselmo Drive, Corona, CA 92879 | 2012-03-13 |
| Find all providers in zip 92879 | ||||
| Taxonomy Code | 251T00000X |
| Grouping | Agencies |
| Classification | PACE Provider Organization |
| A PACE provider organization is a not-for-profit private or public entity that is primarily engaged in providing PACE services(unique capitated managed care benefits for the frail elderly which include comprehensive medical and social services). The following characteristics also apply to a PACE organization. It must: have a governing board that includes community representation; be able to provide complete PACE services regardless of frequency or duration of services; have a physical site to provide adult day services; have a defined service area; have safeguards against conflict of interest; have demonstrated fiscal soundness and have a formal Participant Bill of Rights. |
| Notes: Source: Centers for Medicare and Medicaid, PACE Fact Sheet http://www.cms.hhs.gov/PACE/Downloads/PACEFactSheet.pdf [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871191932 | One Family Health Enterprise | PACE Provider Organization | 206 E 185th St, Carson, CA 90746-1706 | 2020-10-12 |
| 1003445073 | North East Medical Services | PACE Provider Organization | 728 Pacific Ave Ste 201, San Francisco, CA 94133-4449 | 2020-04-02 |
| 1508422775 | Tri Starr Home Care LLC | PACE Provider Organization | 1669 Flanigan Dr., Unit H, San Jose, CA 95121 | 2019-05-14 |
| 1164980439 | Tri Starr Home Care, LLC | PACE Provider Organization | 1609 Flanigan Dr., Unit H, Unit H, San Jose, CA 95122 | 2019-03-06 |
| 1063988384 | Sequoia Pace, LLC. | PACE Provider Organization | 1649 Van Ness Ave, Fresno, CA 93721-1128 | 2018-10-15 |
| 1457838955 | La Coast Pace, LLC | PACE Provider Organization | 1220 E 4th St, Long Beach, CA 90802-1831 | 2018-07-26 |
| 1194202697 | Pacific Pace, LLC | PACE Provider Organization | 50 Alessandro Pl Ste A20, Pasadena, CA 91105-3149 | 2018-07-26 |
| 1356830947 | Stockton Pace | PACE Provider Organization | 582 E. Harding Way, Stockton, CA 95204 | 2018-05-09 |
| 1063901767 | Humboldt Mobile Massage, Inc | PACE Provider Organization | 1737 Margaret Ln, Arcata, CA 95521-6838 | 2018-05-08 |
| 1669986410 | Vast Oceanside Elderly Care | PACE Provider Organization | 452 Foussat Rd, Oceanside, CA 92054-4709 | 2017-11-30 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.