NPIMap

Organization Active NPI

VA Palo Alto Healthcare System

  • VA Clinic/Center
  • San Jose, CA
National Provider Identifier
1003206244
Registry record updated Jan 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
VA Clinic/CenterTaxonomy code 261QV0200X
License
3033 Issued in CA
Legal business name
VA PALO ALTO HEALTHCARE SYSTEM
Practice address
80 Great Oaks Blvd
San Jose, CA 95119-1310
Phone
(408) 363-3000
NPI assigned
Jan 26, 2015
Last updated
Jan 26, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2015

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

Authorized official

Name
Pat Montgomery
Title
Assistant Chief of Audiology
Phone
(650) 493-5000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
VA Clinic/Center 261QV0200X 3033 CA Primary

Addresses

Primary practice location

80 Great Oaks Blvd
San Jose, CA 95119-1310

Mailing address

2521 211TH Ave E
Lake Tapps, WA 98391-9054

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 40

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1422230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422230400000",
    "number": "1003206244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2521 211TH AVE E",
            "city": "LAKE TAPPS",
            "state": "WA",
            "postal_code": "983919054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 GREAT OAKS BLVD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951191310",
            "telephone_number": "408-363-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VA PALO ALTO HEALTHCARE SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-26",
        "last_updated": "2015-01-26",
        "status": "A",
        "authorized_official_last_name": "MONTGOMERY",
        "authorized_official_first_name": "PAT",
        "authorized_official_title_or_position": "ASSISTANT CHIEF OF AUDIOLOGY",
        "authorized_official_telephone_number": "650-493-5000"
    },
    "taxonomies": [
        {
            "code": "261QV0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, VA",
            "state": "CA",
            "license": "3033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.