Individual provider Active NPI

Akhila Mohan, MD

  • Student in an Organized Health Care Education/Training Program
  • San Jose, CA
National Provider Identifier
1104389600
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
227 N Jackson Ave Ste 100
San Jose, CA 95116-1633
Phone
(408) 871-3448
Fax
(408) 871-5215
NPI assigned
Apr 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary
Rheumatology Physician 207RR0500X A198534 CA

Addresses

Primary practice location

227 N Jackson Ave Ste 100
San Jose, CA 95116-1633

Mailing address

973 University Ave
Los Gatos, CA 95032-7636
Phone (408) 871-3200

Other practice location 1

900 S Caton Ave
Baltimore, MD 21229-5201
Phone (667) 234-5724

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
I20241125004119 CA Practitioner - Rheumatology 7416482633 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
El Camino Health Medical Network LLCGroup PAC ID 6103115183, 202 clinicians

Practice addresses (Care Compare)

227 N Jackson Ave
Suite 100
San Jose, CA 95116-1633
Phone (408) 871-3400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A198534CAMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
El Camino Health Medical Network, LLC CurrentSince Jan 1, 2025 Accepting new patients
El Camino Health Medical Group CurrentSince Jan 12, 2025 Accepting new patients

Locations

973 University Ave
Los Gatos, CA 95032
Phone (408) 278-3003

815 Pollard Rd
Los Gatos, CA 95032
Phone (408) 378-6131

227 N Jackson Ave
Ste 100
San Jose, CA 95116
Phone (408) 866-4000

Organizations & group practices 2

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 3

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

NPI Registry JSON

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

{
    "created_epoch": "1554940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1104389600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "973 UNIVERSITY AVE",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950327636",
            "telephone_number": "408-871-3200",
            "fax_number": "408-871-3201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 N JACKSON AVE STE 100",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951161633",
            "telephone_number": "408-871-3448",
            "fax_number": "408-871-5215"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 S Caton Ave",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212295201",
            "country_code": "US",
            "telephone_number": "667-234-5724",
            "fax_number": "667-234-3525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOHAN",
        "first_name": "AKHILA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-11",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "CA",
            "license": "A198534",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.