Individual provider Active NPI

Emma Concepcion Javier, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Palm Desert, CA
National Provider Identifier
1093746299
Registry record updated Oct 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
C53572 Issued in CA
Practice address
75036 Gerald Ford Dr
Palm Desert, CA 92211-2080
Phone
(760) 834-2600
Fax
(760) 834-2570
NPI assigned
Jul 5, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 25MA06712300 NJ
Geriatric Medicine (Internal Medicine) Physician 207RG0300X C53572 CA Primary

Addresses

Primary practice location

75036 Gerald Ford Dr
Palm Desert, CA 92211-2080

Mailing address

75036 Gerald Ford Dr
Palm Desert, CA 92211-2080
Phone (760) 834-2600

Other identifiers 2

IdentifierTypeStateIssuer
0002461MedicaidNJ
0103605000OtherNJAMERIHEALTH

Other names 1

  • Dr. Emma Concepcion Javier Spino Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20090819000827 CA Practitioner - HospitalistPractitioner - Internal MedicinePractitioner - Geriatric Medicine 0042281800 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Jun 8, 2009 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jun 8, 2009 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Regional Physician Services, NJ, PC Past Accepting new patients

Locations

75036 Gerald Ford Dr
Palm Desert, CA 92211
Phone (760) 834-2508

393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914

10800 Magnolia Ave
Riverside, CA 92505
Phone (951) 353-2000

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634169600000",
    "number": "1093746299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75036 GERALD FORD DR",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922112080",
            "telephone_number": "760-834-2600",
            "fax_number": "760-834-2570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75036 GERALD FORD DR",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922112080",
            "telephone_number": "760-834-2600",
            "fax_number": "760-834-2570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAVIER",
        "first_name": "EMMA",
        "middle_name": "CONCEPCION",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2021-10-14",
        "certification_date": "2021-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NJ",
            "license": "25MA06712300",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "CA",
            "license": "C53572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0002461",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "0103605000",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "10800 Magnolia Ave",
            "city": "Riverside",
            "state": "CA",
            "country_code": "US",
            "postal_code": "925053043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "EMMA",
            "last_name": "JAVIER SPINO",
            "middle_name": "CONCEPCION",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Palm Desert, CA

Sources for this page

Verify at the official NPI Registry.