Active NPI
Christopher Jedel, MD
- Student in an Organized Health Care Education/Training Program
- Sacramento, CA
National Provider Identifier
1073373668
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- 390200000X
- Practice address
- 2516 Stockton Blvd
Sacramento, CA 95817-2208 - Phone
- (916) 734-2428
- NPI assigned
- Mar 20, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 390200000X | CA | Primary |
Addresses
Primary practice location
2516 Stockton Blvd
Sacramento, CA 95817-2208
Mailing address
751 5TH St Apt 312
West Sacramento, CA 95605-2824
Phone (929) 760-5090
Other practice location 1
355 Bard Ave
Staten Island, NY 10310-1699
Phone (718) 818-4636
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260413003475 | CA | Order and Referring Only - Pediatric Medicine | 0648745083 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 390200000X | CA | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1710892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752969600000",
"number": "1073373668",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "751 5TH ST APT 312",
"city": "WEST SACRAMENTO",
"state": "CA",
"postal_code": "956052824",
"telephone_number": "929-760-5090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2516 STOCKTON BLVD",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958172208",
"telephone_number": "916-734-2428"
}
],
"practiceLocations": [
{
"address_1": "355 Bard Ave",
"address_purpose": "LOCATION",
"city": "Staten Island",
"state": "NY",
"postal_code": "103101699",
"country_code": "US",
"telephone_number": "718-818-4636",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JEDEL",
"first_name": "CHRISTOPHER",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-03-20",
"last_updated": "2025-07-20",
"certification_date": "2025-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CA",
"license": "390200000X",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.