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JOHN KOLETH MD
NPI 1902086770
Psychiatry & Neurology - Psychiatry in Riverside, CA

Active since November 09, 2007PECOS Enrolled
769 W BLAINE ST, RIVERSIDE, CA 92507(951) 358-4705 Get Directions Write a Review

NPPES record last updated: November 1, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About John Koleth Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JOHN KOLETH MD (NPI 1902086770) is an individual psychiatry provider in Riverside, California, licensed in Pennsylvania (MD421215) and active in the NPI registry since November 2007. He is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1902086770
Entity TypeIndividualMale
Primary Taxonomy2084P0800X
Provider Legal NameJOHN KOLETHCredential: MD
Location Address769 W BLAINE STRiverside, CA 92507-3970
Mailing Address1401 S 31st St, 2nd FloorPhiladelphia, PA 19146-3506 · (215) 925-2400 · Fax (215) 925-9162
Phone(951) 358-4705
Sole ProprietorNo
Enumeration DateNovember 9, 2007
Last NPPES UpdateNovember 1, 2021
NPPES CertifiedNovember 1, 2021
✔ NPI 1902086770 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
License✔ Licensed in PA · MD421215
Definition
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
769 W BLAINE ST, Riverside, CA 92507
Open in Google Maps ↗

Secondary Practice Locations 2

Location 15501 Woodland AvePhiladelphia, PA 19143-5607 · Phone (215) 724-4700 · Fax (215) 724-3111
Location 22085 Rustin AveRiverside, CA 92507-2498 · Phone (951) 955-8000

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

John Koleth Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show John Koleth reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Mellow Medical Inc A Professional Corporation
60 mi
Psychiatry
8235 SANTA MONICA BLVD, SUITE 300
West Hollywood, CA 90046
  • Reassigned Medicare billing, California enrollment
  • 204 clinicians in this Medicare group
NPI 1407275886 (310) 892-4284

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92507 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$179.42 typical visit price
range $59.60 – $179.42
Typical copayment $44.85 (range $14.90 – $44.85)
Most-billed visit code 99205
Established Patient
$74.08 typical visit price
range $19.37 – $146.42
Typical copayment $18.52 (range $4.84 – $36.60)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. MARK ANTHONY SLAUGHTER SR. LVN
Licensed Vocational Nurse
769 W BLAINE ST
RIVERSIDE, CA 92507
Riverside County (951) 358-4705
LILA SAMADY LCSW
Social Worker (Clinical)
769 W BLAINE ST
RIVERSIDE, CA 92507
Riverside County (951) 358-6895
MS. LAVERNE ZETA BENNETT RN,MSN, PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
769 W BLAINE ST
RIVERSIDE, CA 92507
Riverside County (951) 358-4523
JING LU
Psychiatry & Neurology (Psychiatry)
769 W BLAINE ST, SUITE B
RIVERSIDE, CA 92507
Riverside County (951) 358-4705
CLAUDIA ELIAS LVN
Licensed Vocational Nurse
769 W BLAINE ST, SUITE B
RIVERSIDE, CA 92507
Riverside County (951) 358-5001
COUNTY OF RIVERSIDE
Community/Behavioral Health
769 W BLAINE ST, SUITE A
RIVERSIDE, CA 92507
Riverside County (951) 955-8000
COUNTY OF RIVERSIDE
Community/Behavioral Health
769 W BLAINE ST, SUITE B
RIVERSIDE, CA 92507
Riverside County (951) 358-4705
MR. DUSTIN DREW TEXEIRA REGISTERED NURSE
Registered Nurse (Psychiatric/Mental Health, Child & Adolescent)
769 W BLAINE ST, SUITE A
RIVERSIDE, CA 92507
Riverside County (951) 358-6895

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is John Koleth's NPI number?

The NPI number for John Koleth is 1902086770. It was assigned to this individual provider in the NPPES registry on November 9, 2007.

Where is John Koleth located?

John Koleth practices at 769 W Blaine St, Riverside, CA 92507. The listed phone number is (951) 358-4705.

What is John Koleth's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is John Koleth enrolled in Medicare?

Yes. John Koleth is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for John Koleth's services?

According to the CMS Revalidation Reassignment List (October 2026 release), John Koleth reassigns Medicare benefits to Mellow Medical Inc A Professional Corporation (West Hollywood, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for John Koleth's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for John Koleth was last updated on November 1, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.