Individual provider Active NPI

Geraldine Terese O'Shea, DO

  • Internal Medicine Physician
  • Jackson, CA
National Provider Identifier
1013910140
Registry record updated Mar 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A7363 Issued in CA
Practice address
235 New York Ranch Rd
Ste B
Jackson, CA 95642-2147
Phone
(209) 257-1057
Fax
(209) 257-1058
NPI assigned
May 23, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 20A7363 CA Primary

Addresses

Primary practice location

235 New York Ranch Rd
Ste B
Jackson, CA 95642-2147

Mailing address

235 New York Ranch Rd
Ste B
Jackson, CA 95642-2147
Phone (209) 257-1057

Other identifiers 1

IdentifierTypeStateIssuer
00AX73630MedicaidCA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050426000961 CA Practitioner - Internal Medicine 1355380700 Practice locations: Jackson, CA

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
College of Osteo Med of the Pacific at Pomona, 1993
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

235 New York Ranch Rd
Suite B
Jackson, CA 95642-2147

235 New York Ranch Rd
Suite B
Jackson, CA 95642-2173

235 New York Ranch Rd B
Foothills Womens CNT
Jackson, CA 95642-2147
Phone (209) 257-1057

Hospital & facility affiliations

  • United Home Care of Northern California Home health agency, Jackson, CA, CCN 557014
  • Sutter Amador Hospital Hospital, Jackson, CA, CCN 050014
  • Sutter Medical Center, Sacramento Hospital, Sacramento, CA, CCN 050108
  • Mark Twain Medical Center Hospital, San Andreas, CA, CCN 051332

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A7363CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Hospitals Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: geraldine.o.shea.1@1663.direct.athenahealth.com

Organizations & group practices 1

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204675200000",
    "number": "1013910140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 NEW YORK RANCH RD",
            "address_2": "STE B",
            "city": "JACKSON",
            "state": "CA",
            "postal_code": "956422147",
            "telephone_number": "209-257-1057",
            "fax_number": "209-257-1058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 NEW YORK RANCH RD",
            "address_2": "STE B",
            "city": "JACKSON",
            "state": "CA",
            "postal_code": "956422147",
            "telephone_number": "209-257-1057",
            "fax_number": "209-257-1058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'SHEA",
        "first_name": "GERALDINE",
        "middle_name": "TERESE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-05-23",
        "last_updated": "2008-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A7363",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX73630",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, CA

Sources for this page

Verify at the official NPI Registry.