Jason Wyeth Koob, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

A128794 Issued in CA

Practice address

928 Harrison St
Suite 200
San Francisco, CA 94107-1009

Phone

(415) 926-5818

Fax

(844) 610-6728

NPI assigned

Jul 1, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Emergency Medicine

Education

University of Chicago, Pritzker School of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Team Physicians of Northern California Medical Group IncGroup PAC ID 7113215146, 84 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• San Ramon Regional Medical Center Hospital, San Ramon, CA, CCN 050689

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jason.koobmd.p1@direct.plannedparenthoodla.nextgenshare.com

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.

• Team Physicians of Northern California Medical Group Inc

  • Emergency Medicine Physician
  • Pleasanton, CA
  • NPI 1649692716
  Medicare reassignment Care Compare group NPD

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

• San Ramon Regional Medical Center, LLC

  • General Acute Care Hospital
  • San Ramon, CA
  • NPI 1932131489
  Care Compare affiliation

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

{
    "created_epoch": "1246406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453334400000",
    "number": "1093943821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "928 HARRISON ST",
            "address_2": "SUITE 200",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941071009",
            "telephone_number": "415-926-5818",
            "fax_number": "844-610-6728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "928 HARRISON ST",
            "address_2": "SUITE 200",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941071009",
            "telephone_number": "415-926-5818",
            "fax_number": "844-610-6728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOOB",
        "first_name": "JASON",
        "middle_name": "WYETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-01",
        "last_updated": "2016-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A128794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carly Kontra
• Brandon Hyunmo Koo, MD
• Chih Ren Nicholas Koo
• Edward K Koo, LCSW
• John Y.M. Koo, MD
• Makayla Mary Koochou, OD
• Ali Reza Koopah, D.D.S.
• Amir R Koopah, D.D.S.
• Samar Koopah, DDS
• Anna Koops, MFT

• Emergency Medicine Physician in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.