Individual provider Active NPI

Jasmine M Halloran, PAC

  • Physician Assistant
  • Castro Valley, CA
National Provider Identifier
1124090162
Registry record updated Feb 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA19584 Issued in CA
Practice address
20103 Lake Chabot Rd
Emergency Department
Castro Valley, CA 94546
Phone
(510) 727-3015
NPI assigned
Feb 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA051866 PA
Physician Assistant 363A00000X PA19584 CA Primary

Addresses

Primary practice location

20103 Lake Chabot Rd
Emergency Department
Castro Valley, CA 94546

Mailing address

20103 Lake Chabot Rd
Castro Valley, CA 94546-5305
Phone (510) 727-3015

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080618000515 CA Practitioner - Physician Assistant 8123084514 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alameda Health SystemGroup PAC ID 3779494521, 597 clinicians

Practice addresses (Care Compare)

13855 E 14TH St
San Leandro, CA 94578-2611
Phone (510) 357-6500

1411 E 31St St
Oakland, CA 94602-1018
Phone (510) 437-4800

Merit-based Incentive Payment System (MIPS)

Final score
95.17 of 100Reported as group
Quality
86.93
Promoting interoperability
100
Improvement activities
40
Cost
72.6

Merit-based Incentive Payment System (MIPS)

Final score
96.02 of 100Reported as group
Quality
86.75
Improvement activities
40
Cost
77.68

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA051866PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Alameda Health System CurrentSince Mar 31, 2023 Accepting new patients
Alameda Health System CurrentSince Mar 31, 2023 Accepting new patients
Carbon Health Primary Care of California PC PastSince Jul 20, 2025 Accepting new patients
Hayward Sisters Hospital Past Accepting new patients
Alameda Health System Past Accepting new patients

Locations

2070 Clinton Ave
Alameda, CA 94501
Phone (510) 522-3700

1411 E 31st St
Oakland, CA 94602
Phone (510) 437-4323

7677 Oakport St
Ste 1200
Oakland, CA 94621
Phone (510) 618-5768

13855 E 14th St
San Leandro, CA 94578
Phone (510) 357-6500

Interoperability endpoints

  • Direct secure messaging: jhalloran105548@alamedahs.direct-ci.com

Organizations & group practices 7

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": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675814400000",
    "number": "1124090162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20103 LAKE CHABOT RD",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945465305",
            "telephone_number": "510-727-3015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20103 LAKE CHABOT RD",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "94546",
            "telephone_number": "510-727-3015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLORAN",
        "first_name": "JASMINE",
        "middle_name": "M",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-03",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA051866",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA19584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Castro Valley, CA

Sources for this page

Verify at the official NPI Registry.