Douglas Jimenez, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A73110 Issued in CA

Practice address

1300 N Dutton Ave
Santa Rosa, CA 95401-7112

Phone

(707) 459-6861

NPI assigned

Jan 18, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Family Practice

Education

University of California, San Francisco School of Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Santa Rosa Community Health CentersGroup PAC ID 0345130423, 69 clinicians

North State Hospitalist Medical Group IncGroup PAC ID 2668893447, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sutter Santa Rosa Regional Hospital Hospital, Santa Rosa, CA, CCN 050291
• Mercy Medical Center of Mt Shasta Hospital, Mount Shasta, CA, CCN 051319
• Providence Santa Rosa Memorial Hospital Hospital, Santa Rosa, CA, CCN 050174

Merit-based Incentive Payment System (MIPS)

Final score

89.05 of 100Reported as group

Quality

87.64

Promoting interoperability

100

Improvement activities

40

Cost

73.33

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: djimenez312520@direct.ochin.org
• Direct secure messaging: douglas.jimenezmd.p1@direct.ppnorcal.nextgenshare.com
• Direct secure messaging: djimenezmd33596@hisp.ehr.sutterhealth.org

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.

• North State Hospitalist Medical Group, Inc

  • Hospitalist Physician
  • Mount Shasta, CA
  • NPI 1598305682
  Medicare reassignment Care Compare group NPD
• Santa Rosa Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Santa Rosa, CA
  • NPI 1578631172
  Medicare reassignment Care Compare group NPD
• Sutter Bay Medical Foundation

  • Multi-Specialty Clinic/Center
  • Palo Alto, CA
  • NPI 1013950807
  Medicare reassignment Care Compare group NPD
• Planned Parenthood Shasta Diablo Inc

  • Community Health Clinic/Center
  • Concord, CA
  • NPI 1982763090
  Medicare reassignment NPD
• Planned Parenthood Shasta Diablo Inc

  • Clinical Medical Laboratory
  • San Rafael, CA
  • NPI 1750435244
  NPD
• Santa Rosa Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Santa Rosa, CA
  • NPI 1386712065
  NPD
• Santa Rosa Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Santa Rosa, CA
  • NPI 1467180430
  NPD
• Sutter Bay Medical Foundation

  • Clinical Medical Laboratory
  • Santa Clara, CA
  • NPI 1669287033
  NPD
• Sutter Bay Hospitals

  • General Acute Care Hospital
  • Santa Rosa, CA
  • NPI 1740413798
  NPD (past)
• Sutter East Bay Medical Foundation

  • Family Medicine Physician
  • Orinda, CA
  • NPI 1871538769
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Dignity Health

  • Critical Access Hospital
  • Mount Shasta, CA
  • NPI 1518085430
  Care Compare affiliation
• St. Joseph Health Northern California, LLC

  • General Acute Care Hospital
  • Santa Rosa, CA
  • NPI 1134152549
  Care Compare affiliation
• Sutter Bay Hospitals

  • General Acute Care Hospital
  • Santa Rosa, CA
  • NPI 1740413798
  Care Compare affiliation

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532995200000",
    "number": "1154474781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 LOMBARDI CT STE B",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954076793",
            "telephone_number": "707-547-2222",
            "fax_number": "707-547-2229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N DUTTON AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954017112",
            "telephone_number": "707-459-6861"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "751 Lombardi Ct Ste B",
            "address_purpose": "LOCATION",
            "city": "Santa Rosa",
            "state": "CA",
            "postal_code": "954076793",
            "country_code": "US",
            "telephone_number": "707-547-2222",
            "fax_number": "707-547-2229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2018-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A73110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A731100",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tingjen Ji, DDS, MSD
• Anthony Jiang
• Jill Applegate Marriage and Family Therapy, Inc.
• Mariana Jimenez Hernandez
• Carolina Jimenez, NP
• Pamela Jimenez
• Emily Nicole Jirel
• Lynne W Joachim, MFT
• Joanne Ngo & Tina Ngo, DDS, Inc.
• Linda Job

• Family Medicine Physician in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.