Organization Active NPI

California Cardiovascular Consultants

  • Internal Medicine Physician
  • San Leandro, CA
National Provider Identifier
1033308614
Registry record updated Nov 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A53282 Issued in CA
Legal business name
CALIFORNIA CARDIOVASCULAR CONSULTANTS
Practice address
1532 150TH Ave
San Leandro, CA 94578-1823
Phone
(510) 351-6363
Fax
(510) 278-3757
NPI assigned
Oct 18, 2007
Organization subpart
Yes
Parent organization
CALIFORNIA CARDIOVASCULAR CONSULTANTSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 21, 2013

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

Authorized official

Name
Dr. Ashit Jain, M.D.
Title
Ceo
Phone
(510) 351-6363

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X A53282 CA Primary

Addresses

Primary practice location

1532 150TH Ave
San Leandro, CA 94578-1823

Mailing address

1532 150TH Ave
San Leandro, CA 94578-1823
Phone (510) 351-6363

Other identifiers 1

IdentifierTypeStateIssuer
GR0055252MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040205000591 CA Part B Supplier - Clinic/Group Practice 7810800083 Receives reassigned benefits from 47 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fremont, CA; Hayward, CA; Milpitas, CA; Newark, CA; San Jose, CA

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Ca Cardiovascular Consul

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1192665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384992000000",
    "number": "1033308614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1532 150TH AVE",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945781823",
            "telephone_number": "510-351-6363",
            "fax_number": "510-278-3757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1532 150TH AVE",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945781823",
            "telephone_number": "510-351-6363",
            "fax_number": "510-278-3757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA CARDIOVASCULAR CONSULTANTS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CALIFORNIA CARDIOVASCULAR CONSULTANTS",
        "enumeration_date": "2007-10-18",
        "last_updated": "2013-11-21",
        "status": "A",
        "authorized_official_last_name": "JAIN",
        "authorized_official_first_name": "ASHIT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "510-351-6363",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A53282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0055252",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Leandro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.