Jessica Corwin, MD
Individual provider Active NPI Dermatology Physician · Vacaville, CA
NPI 1154523975 · NPPES record last updated May 21, 2024
Key facts
- NPI
- 1154523975
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dermatology Physician 207N00000X
- License
- CMD13390 (RI)
- Practice address
- 1 Quality Dr
Vacaville, CA 95688-9494 - Phone
- (707) 624-3200
- Fax
- (707) 624-3201
- NPI assigned
- Jun 4, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Dermatology
- Education
- Emory University School of Medicine, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Permanente Medical Group Inc
Practice addresses (Care Compare)
1721 W Yosemite Ave
Manteca, CA 95337-5130
Phone (209) 825-3700
1777 W Yosemite Ave
Manteca, CA 95337-5130
Phone (209) 825-3700
1779 W Yosemite Ave
Manteca, CA 95337-5130
Phone (209) 825-3700
1789 W Yosemite Ave
Manteca, CA 95337-5130
Phone (209) 825-3700
7373 W Lane
Stockton, CA 95210-3377
Phone (209) 476-2000
975 Sereno Dr
Vallejo, CA 94589-2441
Phone (707) 651-1000
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
| Skin biopsy | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111109000525 | CA | Practitioner - Dermatology | 2860518925 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CMD13390 | RI | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Permanente Medical Group, Inc | Current |
Accepting new patients | |
| Permanente Medical Group Inc | Dermatology | Current |
Accepting new patients |
| West Bay Dermatology, LTD | Past | Accepting new patients |
Locations
1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015
901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500
2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000
710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400
7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000
1 Quality Dr
Vacaville, CA 95688
Phone (707) 453-5000
975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | CMD13390 | RI | Yes |
Addresses
Primary practice location
1 Quality Dr
Vacaville, CA 95688-9494
Mailing address
1 Quality Dr
Vacaville, CA 95688-9494
Phone (707) 624-3200
Other names
- Jessica Risser
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq | Health Information Exchange (HIE) | The Permanente Medical Group |
Other providers in Vacaville, CA
- Corrections and Rehabilitation-Headquarters
- Corrections and Rehabilitation-Headquarters
- Corrections and Rehabilitation-Headquarters
- Correxus Medical Services
- Georgina M Cortez
- Costco Wholesale Corporation
- Costco Wholesale Corporation
- Costco Wholesale Corporation
- Costco Wholesale Corporation
- Christian Cotsakos
All providers in Vacaville, CA · Dermatology Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 21, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.