NPIMap

Individual provider Active NPI

Ameha Teklu Joba, DPM

  • Foot & Ankle Surgery Podiatrist
  • Rohnert Park, CA
National Provider Identifier
1043506140
Registry record updated Feb 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E5244 Issued in CA
Practice address
1350 Medical Center Dr
Ste B
Rohnert Park, CA 94928-2932
Phone
(707) 586-9300
NPI assigned
Jun 27, 2011
Last updated
Feb 20, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 016.005465 IL
Foot & Ankle Surgery Podiatrist 213ES0103X E5244 CA Primary

Addresses

Primary practice location

1350 Medical Center Dr
Ste B
Rohnert Park, CA 94928-2932

Mailing address

1350 Medical Center Dr
Ste B
Rohnert Park, CA 94928-2932
Phone (707) 586-9300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160818001148 CA Practitioner - Podiatry 1153591250 Reassigns benefits to 1 organization
Practice locations: Hayward, CA

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1350 Medical Ctr Dr
Suite B
Rohnert Park, CA 94928-2932
Phone (707) 586-9300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.4 of 100Reported as individual
Quality
60.72
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue377
Removal of skin lesions1-10
Removal of nail tissue1087
Removal or shaving of skin growth491

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E5244CAMDFoot & Ankle Surgery Podiatrist
016.005465ILMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph Health Northern California, LLC Past Accepting new patients
Michael M. Maghrabi DPM, PC Foot & Ankle Surgery PastSince Jun 1, 1990 Accepting new patients
Sutter Bay Hospitals Past Accepting new patients
Providence Medical Foundation Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ajoba365395@hisp.ehr.sutterhealth.org

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.

Hospital & facility affiliations 2

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": "1309132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487548800000",
    "number": "1043506140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 MEDICAL CENTER DR",
            "address_2": "STE B",
            "city": "ROHNERT PARK",
            "state": "CA",
            "postal_code": "949282932",
            "telephone_number": "707-586-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 MEDICAL CENTER DR",
            "address_2": "STE B",
            "city": "ROHNERT PARK",
            "state": "CA",
            "postal_code": "949282932",
            "telephone_number": "707-586-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOBA",
        "first_name": "AMEHA",
        "middle_name": "TEKLU",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-27",
        "last_updated": "2017-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016.005465",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E5244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rohnert Park, CA

Sources for this page

Verify at the official NPI Registry.