Individual provider Active NPI

An-an Jiang, DPM

  • Student in an Organized Health Care Education/Training Program
  • Vallejo, CA
National Provider Identifier
1023462629
Registry record updated Dec 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
975 Sereno Dr
Kaiser Permanente Vallejo Medical Center
Vallejo, CA 94589-2441
Phone
(707) 651-1000
NPI assigned
Apr 20, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

975 Sereno Dr
Kaiser Permanente Vallejo Medical Center
Vallejo, CA 94589-2441

Mailing address

975 Sereno Dr
Kaiser Permanente Vallejo Medical Center
Vallejo, CA 94589-2441
Phone (707) 651-1000

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190724001470 CA Practitioner - Podiatry 5395071666 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

9333 Imperial Hwy
Downey, CA 90242-2812
Phone (800) 923-4040

9333 Rosecrans Ave
Bellflower, CA 90706-2141
Phone (562) 461-3000

9353 Imperial Hwy
Downey, CA 90242-2812
Phone (562) 657-9000

9400 Rosecrans Ave
Bellflower, CA 90706-2246
Phone (562) 461-3000

9449 Imperial Hwy
Downey, CA 90242-2814
Phone (562) 461-3000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Oct 28, 2019 Accepting new patients
Southern California Permanente Medical Group CurrentSince Oct 28, 2019 Accepting new patients
South Bay Foot & Ankle Specialists, Inc. CurrentSince Jul 22, 2019 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
South Bay Foot & Ankle Specialists, Inc. CurrentSince Jul 22, 2019 Accepting new patients

Locations

5475 E La Palma Ave
Anaheim, CA 92807
Phone (714) 279-6088

9333 Rosecrans Ave
Bellflower, CA 90706
Phone (562) 461-3340

345 F St
Ste 100
Chula Vista, CA 91910
Phone (619) 420-3555

9333 Imperial Hwy
Downey, CA 90242
Phone (562) 657-8850

610 Euclid Ave
Ste 301
National City, CA 91950
Phone (619) 292-2493

Organizations & group practices 5

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 1

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": "1461110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639353600000",
    "number": "1023462629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 SERENO DR",
            "address_2": "KAISER PERMANENTE VALLEJO MEDICAL CENTER",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945892441",
            "telephone_number": "707-651-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 SERENO DR",
            "address_2": "KAISER PERMANENTE VALLEJO MEDICAL CENTER",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945892441",
            "telephone_number": "707-651-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIANG",
        "first_name": "AN-AN",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-20",
        "last_updated": "2021-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9333 Imperial Hwy",
            "city": "Downey",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902422812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Vallejo, CA

Sources for this page

Verify at the official NPI Registry.