Individual provider Active NPI

Stephen Jacob Harris, MD

  • Pediatrics Physician
  • San Jose, CA
National Provider Identifier
1124082516
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
G69137 Issued in CA
Practice address
751 S Bascom Ave
Pediatrics Department
San Jose, CA 95128-2604
Phone
(408) 885-5445
NPI assigned
Apr 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X G69137 CA Primary

Addresses

Primary practice location

751 S Bascom Ave
Pediatrics Department
San Jose, CA 95128-2604

Mailing address

751 S Bascom Ave
San Jose, CA 95128-2604
Phone (408) 885-5000

Other practice location 1

1510 Capitola Rd
Santa Cruz, CA 95062-2912
Phone (831) 427-3500

Other identifiers 1

IdentifierTypeStateIssuer
00G691370MedicaidCA

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
I20191102000300 CA Practitioner - Pediatric Medicine 0244562726 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G69137CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Santa Clara Pediatrics Current Accepting new patients
County of Santa Clara CurrentSince Sep 1, 2019 Accepting new patients
County of Santa Clara Current Accepting new patients
County of Santa Clara CurrentSince Sep 1, 2019 Accepting new patients
County of Santa Clara CurrentSince Sep 1, 2019 Accepting new patients
County of Santa Clara CurrentSince Sep 1, 2019 Accepting new patients
Santa Cruz Community Health Centers Past Accepting new patients

Locations

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

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

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

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

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

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

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

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

Interoperability endpoints

  • Direct secure messaging: sharris313465@hisp.ehr.sutterhealth.org
  • Direct secure messaging: sharris10716@santaclaravalley.direct-ci.net

Organizations & group practices 8

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": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1124082516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 S BASCOM AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282604",
            "telephone_number": "408-885-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 S BASCOM AVE",
            "address_2": "PEDIATRICS DEPARTMENT",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282604",
            "telephone_number": "408-885-5445"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1510 Capitola Rd",
            "address_purpose": "LOCATION",
            "city": "Santa Cruz",
            "state": "CA",
            "postal_code": "950622912",
            "country_code": "US",
            "telephone_number": "831-427-3500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "STEPHEN",
        "middle_name": "JACOB",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-13",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G69137",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G691370",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.