Individual provider Active NPI

Jeff W Chiu, D.O.

  • Emergency Medicine Physician
  • San Jose, CA
National Provider Identifier
1104279348
Registry record updated Jul 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
20A15789 Issued in CA
Practice address
851 S Bacom Ave
San Jose, CA 95128
Phone
(408) 885-5000
Fax
(513) 715-4076
NPI assigned
Jul 22, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A15789 CA
Emergency Medicine Physician 207P00000X 20A15789 CA Primary

Addresses

Primary practice location

851 S Bacom Ave
San Jose, CA 95128

Mailing address

1001 Galaxy Way Ste 400
Concord, CA 94520-5725
Phone (925) 482-8402

Other practice location 1

2222 Bancroft Way
Berkeley, CA 94720-4301
Phone (510) 642-6621

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
I20190702003279 CA Practitioner - Family Practice 0547594079 Reassigns benefits to 6 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A15789CAMDFamily Medicine Physician
15789CAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Contra Costa County CurrentSince May 15, 2025 Accepting new patients
Chavez Emergency Physicians Medical Group, Inc. Emergency Medicine CurrentSince Aug 1, 2019 Accepting new patients
County of Santa Clara Current Accepting new patients
Contra Costa County CurrentSince May 15, 2025 Accepting new patients
County of Santa Clara CurrentSince May 5, 2019 Accepting new patients
County of Santa Clara CurrentSince May 5, 2019 Accepting new patients
County of Santa Clara CurrentSince May 5, 2019 Accepting new patients
County of Santa Clara CurrentSince May 5, 2019 Accepting new patients
Sonoma Valley Emergency Physicians Medical Group, Inc Emergency Medicine CurrentSince Aug 1, 2020 Accepting new patients
County of Santa Clara Emergency Medicine Current Accepting new patients

Locations

7475 Camino Arroyo
Gilroy, CA 95020
Phone (408) 852-2400

2500 Alhambra Ave
Martinez, CA 94553
Phone (925) 370-5000

400 N McDowell Blvd
Petaluma, CA 94954
Phone (707) 778-1111

1065 Bucks Lake Rd
Quincy, CA 95971
Phone (530) 283-2121

750 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-2320

1996 Lundy Ave
San Jose, CA 95131
Phone (408) 299-5846

500 Tully Rd
San Jose, CA 95111
Phone (408) 817-1433

2101 Alexian Dr
San Jose, CA 95116
Phone (408) 272-6050

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

1993 McKee Rd
San Jose, CA 95116
Phone (408) 254-6320

2523 El Portal Dr
Ste 206
San Pablo, CA 94806
Phone (510) 215-3730

660 S Fair Oaks Ave
Sunnyvale, CA 94086
Phone (408) 885-7366

Interoperability endpoints

  • Direct secure messaging: jchiu137074@santaclaravalley.direct-ci.net

Organizations & group practices 10

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": "1469145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596153600000",
    "number": "1104279348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 GALAXY WAY STE 400",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945205725",
            "telephone_number": "925-482-8402",
            "fax_number": "925-482-2825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 S BACOM AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "95128",
            "telephone_number": "408-885-5000",
            "fax_number": "513-715-4076"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2222 Bancroft Way",
            "address_purpose": "LOCATION",
            "city": "Berkeley",
            "state": "CA",
            "postal_code": "947204301",
            "country_code": "US",
            "telephone_number": "510-642-6621",
            "fax_number": "510-642-1801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHIU",
        "first_name": "JEFF",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-22",
        "last_updated": "2020-07-31",
        "certification_date": "2020-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A15789",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "20A15789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.