Individual provider Active NPI

Jaesu Han, MD

  • Family Medicine Physician
  • Sacramento, CA
National Provider Identifier
1104802149
Registry record updated Feb 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A066813 Issued in CA
Practice address
2230 Stockton Blvd
Sacramento, CA 95817-1419
Phone
(916) 734-2972
NPI assigned
Dec 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A066813 CA
Family Medicine Physician 207Q00000X A066813 CA Primary

Addresses

Primary practice location

2230 Stockton Blvd
Sacramento, CA 95817-1419

Mailing address

2230 Stockton Blvd
Sacramento, CA 95817-1419
Phone (916) 734-2972

Other identifiers 1

IdentifierTypeStateIssuer
00A668130MedicaidCA

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
I20050919001049 CA Practitioner - PsychiatryPractitioner - Family Practice 0345274494 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Family Practice
Education
University of California, Davis School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Department of PsychiatryGroup PAC ID 6901700384, 29 clinicians
University of California IrvineGroup PAC ID 5395658181, 57 clinicians

Practice addresses (Care Compare)

101 The City Dr S
Orange, CA 92868-3201
Phone (714) 456-8068

800 N Main St
Santa Ana, CA 92701-3576
Phone (714) 456-6324

Hospital & facility affiliations

  • Uci Health-Orange Hospital, Orange, CA, CCN 050348

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
83.7
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A066813CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca Current Accepting new patients
Regents of the University of Ca CurrentSince Aug 25, 1983 Accepting new patients
Regents of the Univ of Ca CurrentSince Aug 25, 1983 Accepting new patients
University of California Irvine CurrentSince Nov 30, 2017 Accepting new patients
The Department of Psychiatry Psychiatry CurrentSince Jul 12, 2017 Accepting new patients
University of California Irvine Current Accepting new patients
Regents of the University of Family Medicine CurrentSince Nov 30, 2017 Accepting new patients
University of California Irvine CurrentSince Nov 30, 2017 Accepting new patients
University of California Irvine Past Accepting new patients
University of California Irvine Past Accepting new patients

Locations

300 W Carl Karcher Way
Anaheim, CA 92801
Phone (657) 282-6356

20350 SW Birch St
Newport Beach, CA 92660
Phone (714) 415-7017

3800 W Chapman Ave
Ste 500
Orange, CA 92868
Phone (714) 456-5770

101 The City Dr S
Bldg 3
Orange, CA 92868
Phone (714) 456-5770

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

4860 Y St
Sacramento, CA 95817
Phone (916) 734-2700

2230 Stockton Blvd
Sacramento, CA 95817
Phone (916) 734-2614

2315 Stockton Blvd
Sacramento, CA 95817
Phone (916) 703-3030

800 N Main St
Santa Ana, CA 92701
Phone (714) 456-6324

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.

Hospital & facility affiliations 2

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": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297036800000",
    "number": "1104802149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2230 STOCKTON BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958171419",
            "telephone_number": "916-734-2972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2230 STOCKTON BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958171419",
            "telephone_number": "916-734-2972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAN",
        "first_name": "JAESU",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-21",
        "last_updated": "2011-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A066813",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A066813",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A668130",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.