Individual provider Active NPI

Jonathan Fish, M.D.

  • Diagnostic Radiology Physician
  • Walnut Creek, CA
National Provider Identifier
1033146758
Registry record updated Apr 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
G14910 Issued in CA
Practice address
2125 Oak Grove Rd
Suite 200
Walnut Creek, CA 94598-2536
Phone
(925) 296-7150
Fax
(925) 296-7171
NPI assigned
Jun 27, 2006
Last updated
Apr 2, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X G14910 CA Primary

Addresses

Primary practice location

2125 Oak Grove Rd
Suite 200
Walnut Creek, CA 94598-2536

Mailing address

2125 Oak Grove Rd
Suite 200
Walnut Creek, CA 94598-2536
Phone (925) 296-7150

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
I20040921000878 CA Practitioner - Diagnostic Radiology 6507834157 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G14910CAMDDiagnostic Radiology Physician
14910CAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
John Muir Trauma Physicians Billing Service Current Accepting new patients
Quality Medical Imaging of Nevada LLC CurrentSince Jan 21, 2021 Accepting new patients
John Muir Trauma Physicians Billing Service Diagnostic Radiology CurrentSince Aug 20, 2018 Accepting new patients
Neuroscan Diagnostic Radiology Past Accepting new patients
John Muir Magnetic Imaging Center Diagnostic Radiology PastSince Mar 7, 1991 Accepting new patients
John Muir Health Past Accepting new patients

Locations

2540 East St
Concord, CA 94520
Phone (925) 674-2228

1601 Ygnacio Valley Rd
Walnut Creek, CA 94598
Phone (925) 295-1545

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427932800000",
    "number": "1033146758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2125 OAK GROVE RD",
            "address_2": "SUITE 200",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945982536",
            "telephone_number": "925-296-7150",
            "fax_number": "925-296-7171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2125 OAK GROVE RD",
            "address_2": "SUITE 200",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945982536",
            "telephone_number": "925-296-7150",
            "fax_number": "925-296-7171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISH",
        "first_name": "JONATHAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2015-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G14910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

Verify at the official NPI Registry.