NPIMap

Individual provider Active NPI

Deepa Vincent, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • San Leandro, CA
National Provider Identifier
1053727305
Registry record updated Mar 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
A158908 Issued in CA
Practice address
1532 150TH Ave
San Leandro, CA 94578
Phone
(510) 351-6363
NPI assigned
Jul 8, 2014
Last updated
Mar 30, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A158908 CA
Endocrinology, Diabetes & Metabolism Physician 207RE0101X A158908 CA Primary

Addresses

Primary practice location

1532 150TH Ave
San Leandro, CA 94578

Mailing address

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

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
I20201030000565 CA Practitioner - EndocrinologyPractitioner - Internal Medicine 6507116381 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dr Aditya Jain MD IncGroup PAC ID 4183854821, 6 clinicians

Practice addresses (Care Compare)

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

2333 Mowry Ave
Suite 300
Fremont, CA 94538-1626
Phone (510) 670-1111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A158908CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Aditya Jain MD Inc Internal Medicine CurrentSince Oct 1, 2020 Accepting new patients

Locations

1532 150th Ave
Ashland, CA 94578
Phone (510) 351-6363

19830 Lake Chabot Rd
Ste C
Castro Valley, CA 94546
Phone (510) 537-3325

2333 Mowry Ave
Ste 300
Fremont, CA 94538
Phone (510) 670-1111

27206 Calaroga Ave
Ste 205
Hayward, CA 94545
Phone (510) 470-4944

Organizations & group practices 1

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 7

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": "1404777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648598400000",
    "number": "1053727305",
    "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": "94578",
            "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": "94578",
            "telephone_number": "510-351-6363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINCENT",
        "first_name": "DEEPA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-08",
        "last_updated": "2022-03-30",
        "certification_date": "2022-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A158908",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CA",
            "license": "A158908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Leandro, CA

Sources for this page

Verify at the official NPI Registry.