Individual provider Active NPI

Anjali Jain, M.D.

  • Pediatric Endocrinology Physician
  • San Jose, CA
National Provider Identifier
1174707392
Registry record updated Aug 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
A104832 Issued in CA
Practice address
2690 S White Rd Ste 50
San Jose, CA 95148-2075
Phone
(408) 223-7000
Fax
(408) 223-7001
NPI assigned
Dec 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Endocrinology Physician 2080P0205X A104832 CA Primary

Addresses

Primary practice location

2690 S White Rd Ste 50
San Jose, CA 95148-2075

Mailing address

2690 S White Rd Ste 50
San Jose, CA 95148-2075
Phone (408) 223-7000

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
I20130109000264 CA Practitioner - Pediatric Medicine 2163675893 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
LPCH Medical Group Div of Lucile CurrentSince Jul 16, 2014 Accepting new patients

Locations

101 Rowland Way
Ste 220
Novato, CA 94945
Phone (415) 878-7200

725 Welch Rd
Palo Alto, CA 94304
Phone (650) 497-8979

4000 Civic Center Dr
Ste 205
San Rafael, CA 94903
Phone (415) 479-7244

Organizations & group practices 1

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": "1198454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407888000000",
    "number": "1174707392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2690 S WHITE RD STE 50",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951482075",
            "telephone_number": "408-223-7000",
            "fax_number": "408-223-7001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2690 S WHITE RD STE 50",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951482075",
            "telephone_number": "408-223-7000",
            "fax_number": "408-223-7001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAIN",
        "first_name": "ANJALI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-24",
        "last_updated": "2014-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "CA",
            "license": "A104832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.