Kaiser Foundation Hospitals

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

License

070000661 Issued in CA

Legal business name

KAISER FOUNDATION HOSPITALS

Practice address

1721 Technology Dr Ste 245
San Jose, CA 95110-1305

Phone

(408) 436-4300

Fax

(408) 436-4310

NPI assigned

Jun 12, 2018

Organization subpart

Yes

Parent organization

KAISER FOUNDATION HOSPITALSAs reported in NPPES

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

Authorized official

Name

Alfred Aghajani

Title

Finance Supervisor

Phone

(626) 405-6347

Specialties & licenses 1

Addresses

Other names 1

• Kaiser Foundation Hospital - Santa Clara ESRD (Skyport) Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

Kaiser Permanente - SkyportCCN 053528

Overall star rating

4.0 of 5

Ownership

Non-profit

Certified

Nov 9, 2018

Medicare certification status

ActiveFrom the Provider of Services file

Chain

Kaiser Permanente

Part of

Kaiser Foundation

Locations

All facility ownership & control disclosures 80

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• George Lai, M.D.

  • Nephrology Physician
  • Hayward, CA
  • NPI 1043398803

  Dialysis facility

  Care Compare affiliation Name & address match

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1528761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618358400000",
    "number": "1134612468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1721 TECHNOLOGY DR STE 245",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951101305",
            "telephone_number": "408-436-4300",
            "fax_number": "408-436-4310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 TECHNOLOGY DR STE 245",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951101305",
            "telephone_number": "408-436-4300",
            "fax_number": "408-436-4310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER FOUNDATION HOSPITALS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KAISER FOUNDATION HOSPITALS",
        "enumeration_date": "2018-06-12",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A",
        "authorized_official_last_name": "AGHAJANI",
        "authorized_official_first_name": "ALFRED",
        "authorized_official_title_or_position": "FINANCE SUPERVISOR",
        "authorized_official_telephone_number": "626-405-6347"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "CA",
            "license": "070000661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdresponding",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1721 Technology Dr Ste 245",
            "city": "San Jose",
            "state": "CA",
            "country_code": "US",
            "postal_code": "951101305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Kaiser Foundation Hospital - Santa Clara ESRD (Skyport)",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kaiser Foundation Hospital - Santa Clara ESRD (Skyport)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kaiser Foundation Health Plan Inc
• Kaiser Foundation Health Plan Inc
• Kaiser Foundation Health Plan Inc
• Kaiser Foundation Health Plan Inc
• Kaiser Foundation Hospitals
• Kaiser Foundation Hospitals
• Kaiser Foundation Hospitals
• Kaiser Permanente
• Kaiser Permanente
• Kaiser Permanente

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in San Jose, CA
• Providers in San Jose, CA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.