Individual provider Active NPI

Elizabeth J. Dubose, M.D.

  • Radiation Oncology Physician
  • San Jose, CA
National Provider Identifier
1124081245
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
G74545 Issued in CA
Practice address
798 S Winchester Blvd
San Jose, CA 95128-2928
Phone
(408) 984-7226
NPI assigned
Apr 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 32676 KY
Radiation Oncology Physician 2085R0001X G74545 CA Primary
Specialist 174400000X G74545 CA

Addresses

Primary practice location

798 S Winchester Blvd
San Jose, CA 95128-2928

Mailing address

PO Box 1631
Evansville, IN 47706-0032
Phone (844) 825-9300

Other practice location 1

2365 Quimby Rd Ste 100
San Jose, CA 95122-1337
Phone (669) 888-0001

Other identifiers 1

IdentifierTypeStateIssuer
1124081245MedicaidCA

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
I20040223000269 CA Practitioner - Diagnostic Radiology 2365338985 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health Diagnostics of California a Professional Corporation 176 clinicians
Smi Imaging LLC 380 clinicians
Silver Creek Radiology Professional Corporation 18 clinicians
Inview Imaging Diagnostics Inc a Professional Medical Corporation 19 clinicians

Practice addresses (Care Compare)

1825 Civic Ctr Dr
Suite 1
Santa Clara, CA 95050-7302
Phone (408) 296-5555

2072 Camino de Los Robles
Menlo Park, CA 94025-5917
Phone (480) 306-6949

21030 Redwood Rd
Suite B
Castro Valley, CA 94546-5920
Phone (510) 856-4800

2365 Quimby Rd
Suite 100
San Jose, CA 95122-1337
Phone (669) 888-0001

325 Sacramento St
San Francisco, CA 94111-3601
Phone (415) 321-4674

3450 Hillcrest Ave
Antioch, CA 94531-8238
Phone (925) 757-2100

665 Munras Ave
Suite 109
Monterey, CA 93940-3136
Phone (831) 656-9800

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32676KYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Heartland Diagnostics, LLC Diagnostic Radiology CurrentSince Oct 1, 2018 Accepting new patients
Heartland Diagnostics, LLC Diagnostic Radiology CurrentSince Sep 24, 2018 Accepting new patients
Health Diagnostics of California a Professional Corporation Diagnostic Radiology CurrentSince Dec 16, 2024 Accepting new patients
Heartland Diagnostics, LLC Diagnostic Radiology CurrentSince Aug 15, 2018 Accepting new patients
Silver Creek Radiology Professional Corporation Diagnostic Radiology CurrentSince Feb 14, 2024 Accepting new patients
Smi Imaging, LLC Diagnostic Radiology CurrentSince Dec 16, 2024 Accepting new patients
Castro Valley Open MRI Medical Group Inc CurrentSince Mar 1, 2020 Accepting new patients
Health Diagnostics of California a Professional Corporation Diagnostic Radiology CurrentSince Dec 16, 2024 Accepting new patients
Inview Imaging Diagnostics Inc a Professional Medical Corporation Diagnostic Radiology CurrentSince Feb 1, 2024 Accepting new patients
Insight Health Corp Past Accepting new patients

Locations

3450 Hillcrest Ave
Antioch, CA 94531
Phone (925) 757-2100

21030 Redwood Rd
Ste B
Castro Valley, CA 94546
Phone (510) 856-4800

39465 Paseo Padre Pkwy
Ste 1000
Fremont, CA 94538
Phone (310) 222-5015

665 Munras Ave
Ste 109
Monterey, CA 93940
Phone (831) 656-9800

225 W Hospitality Ln
Ste 102
San Bernardino, CA 92408
Phone (909) 888-5000

325 Sacramento St
San Francisco, CA 94111
Phone (408) 356-9013

325 Sacramento St
#1112
San Francisco, CA 94111
Phone (408) 356-9013

2365 Quimby Rd
Ste 100
San Jose, CA 95122
Phone (650) 964-1505

7807 Shelbyville Rd
Ste 100
Louisville, KY 40222
Phone (502) 426-6500

7807 Shelbyville Rd
Ste 10
Louisville, KY 40222
Phone (502) 429-8998

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": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1124081245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1631",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477060032",
            "telephone_number": "844-825-9300",
            "fax_number": "775-852-6902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "798 S WINCHESTER BLVD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282928",
            "telephone_number": "408-984-7226"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2365 Quimby Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951221337",
            "country_code": "US",
            "telephone_number": "669-888-0001",
            "fax_number": "669-888-0551",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUBOSE",
        "first_name": "ELIZABETH",
        "middle_name": "J.",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-10",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "KY",
            "license": "32676",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "CA",
            "license": "G74545",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G74545",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124081245",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.