NPIMap

Individual provider Active NPI

Josephus-Ian Lumongsud Sanjorjo, MD

  • Nephrology Physician
  • Daly City, CA
National Provider Identifier
1073808168
Registry record updated Feb 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A117377 Issued in CA
Practice address
1800 Sullivan Ave
Suite 507
Daly City, CA 94015-2228
Phone
(650) 817-7188
Fax
(650) 513-8788
NPI assigned
Jun 16, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A117377 CA
Nephrology Physician 207RN0300X A117377 CA Primary
Hospitalist Physician 208M00000X A117377 CA

Addresses

Primary practice location

1800 Sullivan Ave
Suite 507
Daly City, CA 94015-2228

Mailing address

1800 Sullivan Ave
Suite 507
Daly City, CA 94015-2228
Phone (650) 817-7188

Other identifiers 2

IdentifierTypeStateIssuer
H26222966OtherPTAN
12257286OtherCAQH

Other names 1

  • Dr. Josephus-Ian Lumongsud Sanjorjo Professional name

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
I20150117000293 CA Practitioner - NephrologyPractitioner - Internal Medicine 6901084227 Reassigns benefits to 4 organizations
Practice locations: Daly City, CA

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
San Mateo Dialysis AssociatesGroup PAC ID 5193719268, 7 clinicians
County of San MateoGroup PAC ID 9032023171, shared by 15 NPIs, 316 clinicians

Practice addresses (Care Compare)

1750 El Camino Real
Suite 15
Burlingame, CA 94010-3208
Phone (650) 692-6302

1800 Sullivan Ave
Suite 507
Daly City, CA 94015-2225
Phone (650) 817-7188

22 W 39TH Ave
Hos316Ms
San Mateo, CA 94403-4364

222 W 39TH Ave
San Mateo, CA 94403-4364

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A117377CAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Mateo CurrentSince Nov 8, 2014 Accepting new patients
San Mateo Dialysis Associates Nephrology CurrentSince Jan 3, 2015 Accepting new patients
County of San Mateo CurrentSince Aug 1, 2017 Accepting new patients
West Bay Nephrology Associates Nephrology CurrentSince Jan 1, 2015 Accepting new patients
County of San Mateo CurrentSince Nov 8, 2014 Accepting new patients
California Pacific Medical Group, Inc. Past Accepting new patients

Locations

1750 El Camino Real
Ste 15
Burlingame, CA 94010
Phone (650) 570-2273

1498 Southgate Ave
#102
Daly City, CA 94015
Phone (650) 755-4490

1800 Sullivan Ave
Rm 507
Daly City, CA 94015
Phone (650) 994-2700

222 W 39th Ave
San Mateo, CA 94403
Phone (415) 573-2222

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17475/brand/1/csg/1/fhir/r4
  • Direct secure messaging: jsanjorjo19361@smch.direct-ci.com
  • Direct secure messaging: jsanjorjo268170@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 and National Provider Directory roles.

Hospital & facility affiliations 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1308182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423267200000",
    "number": "1073808168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 SULLIVAN AVE",
            "address_2": "SUITE 507",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940152228",
            "telephone_number": "650-817-7188",
            "fax_number": "650-513-8788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 SULLIVAN AVE",
            "address_2": "SUITE 507",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940152228",
            "telephone_number": "650-817-7188",
            "fax_number": "650-513-8788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANJORJO",
        "first_name": "JOSEPHUS-IAN",
        "middle_name": "LUMONGSUD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-16",
        "last_updated": "2015-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A117377",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A117377",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A117377",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "H26222966",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12257286",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOSEPHUS-IAN",
            "last_name": "SANJORJO",
            "middle_name": "LUMONGSUD",
            "prefix": "DR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Daly City, CA

Sources for this page

Verify at the official NPI Registry.