Organization Active NPI

Hector de Jesus M.D., Inc

  • Specialist
  • Bakersfield, CA
National Provider Identifier
1053593277
Registry record updated May 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
OOA602230 Issued in CA
Legal business name
HECTOR DE JESUS M.D., INC
Practice address
2121 17TH St Ste a
Bakersfield, CA 93301-3704
Phone
(661) 323-3280
Fax
(661) 323-3388
NPI assigned
Nov 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2021

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

Authorized official

Name
Hector M De Jesus, M. D.NPI 1063591790
Title
President
Phone
(661) 323-3280

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X OOA602230 CA Primary

Addresses

Primary practice location

2121 17TH St Ste a
Bakersfield, CA 93301-3704

Mailing address

PO Box 2647
Bakersfield, CA 93303-2647
Phone (661) 323-3280

Other identifiers 1

IdentifierTypeStateIssuer
OOA602230MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080423000277 CA Part B Supplier - Clinic/Group Practice 0143308767 Receives reassigned benefits from 1 practitioner
Practice locations: Bakersfield, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1196294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621987200000",
    "number": "1053593277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2647",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933032647",
            "telephone_number": "661-323-3280",
            "fax_number": "661-323-3388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 17TH ST STE A",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933013704",
            "telephone_number": "661-323-3280",
            "fax_number": "661-323-3388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HECTOR DE JESUS M.D., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-29",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A",
        "authorized_official_last_name": "DE JESUS",
        "authorized_official_first_name": "HECTOR",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "661-323-3280",
        "authorized_official_credential": "M. D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "OOA602230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OOA602230",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2021; 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.