Individual provider Active NPI

Nejat Arab Jalisi, M.D.

  • Family Medicine Physician
  • El Cajon, CA
National Provider Identifier
1063651552
Registry record updated Sep 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A105304 Issued in CA
Practice address
1320 E Madison Ave
El Cajon, CA 92021-8531
Phone
(619) 456-9800
Fax
(619) 456-9804
NPI assigned
Feb 6, 2009
Last updated
Sep 6, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A105304 CA Primary

Addresses

Primary practice location

1320 E Madison Ave
El Cajon, CA 92021-8531

Mailing address

1320 E Madison Ave
El Cajon, CA 92021-8531
Phone (619) 456-9800

Other identifiers 1

IdentifierTypeStateIssuer
A105304OtherCATHE MEDICAL BOARD OF CALIFORNIA

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
I20090316000582 CA Practitioner - Family Practice 2567529738 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1320 E Madison Ave
El Cajon, CA 92021-8531
Phone (619) 456-9800

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
105304CAMDMarriage & Family Therapist
A105304CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University Health Ball Memorial Hospital, Inc. Past Accepting new patients
Grossmont Hospital Corporation PastSince Apr 1, 2013 Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

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 3

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": "1233878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536192000000",
    "number": "1063651552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 E MADISON AVE",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920218531",
            "telephone_number": "619-456-9800",
            "fax_number": "619-456-9804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 E MADISON AVE",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920218531",
            "telephone_number": "619-456-9800",
            "fax_number": "619-456-9804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JALISI",
        "first_name": "NEJAT",
        "middle_name": "ARAB",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-06",
        "last_updated": "2018-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A105304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THE MEDICAL BOARD OF CALIFORNIA",
            "identifier": "A105304",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Cajon, CA

Sources for this page

Verify at the official NPI Registry.