NPIMap

Individual provider Active NPI

Jacob R Wouden, M.D.

  • Diagnostic Radiology Physician
  • Fremont, CA
National Provider Identifier
1114964160
Registry record updated Aug 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A106813 Issued in CA
Practice address
2000 Mowry Ave
Washington Radiologists Medical Group
Fremont, CA 94538-1716
Phone
(617) 797-1111
NPI assigned
May 31, 2006
Last updated
Aug 27, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X A106813 CA Primary

Addresses

Primary practice location

2000 Mowry Ave
Washington Radiologists Medical Group
Fremont, CA 94538-1716

Mailing address

2000 Mowry Ave
Washington Radiologists Medical Group
Fremont, CA 94538-1716
Phone (617) 797-1111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090818000656 CA Practitioner - Diagnostic Radiology 4789738279 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Harvard Medical School, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington Radiologists Medical Group IncGroup PAC ID 6305927245, 66 clinicians

Practice addresses (Care Compare)

2000 Mowry Ave
Fremont, CA 94538-1716
Phone (510) 797-1111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Healthcare Services Inc CurrentSince Apr 4, 2007 Accepting new patients
Washington Radiologists Medical Group, Inc. CurrentSince Aug 1, 2009 Accepting new patients
Washington Township Hospital District Past Accepting new patients
Alliance Healthcare Services Inc PastSince Sep 4, 2012 Accepting new patients

Locations

2000 Mowry Ave
Fremont, CA 94538
Phone (510) 793-6653

2500 Mowry Ave
Fremont, CA 94538
Phone (510) 248-1000

Interoperability endpoints

  • Direct secure messaging: jwouden13927@direct.whhs.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251331200000",
    "number": "1114964160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 MOWRY AVE",
            "address_2": "WASHINGTON RADIOLOGISTS MEDICAL GROUP",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381716",
            "telephone_number": "617-797-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 MOWRY AVE",
            "address_2": "WASHINGTON RADIOLOGISTS MEDICAL GROUP",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381716",
            "telephone_number": "617-797-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOUDEN",
        "first_name": "JACOB",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2009-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A106813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

Verify at the official NPI Registry.