Individual provider Active NPI

John Peter Daly, M.D.

  • Psychiatry Physician
  • San Jose, CA
National Provider Identifier
1174950992
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A127297 Issued in CA
Practice address
150 W Hedding St FL 1
San Jose, CA 95110-1706
Phone
(408) 808-5299
Fax
(888) 377-2923
NPI assigned
Oct 11, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A127297 CA Primary

Addresses

Primary practice location

150 W Hedding St FL 1
San Jose, CA 95110-1706

Mailing address

702 Meridian Ave Ste L #285
San Jose, CA 95125-5586
Phone (831) 345-3735

Other practice location 1

25 Allen St, STE B
Martinez, CA 94553
Phone (408) 364-7069

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
I20181206003248 CA Practitioner - Psychiatry 5799029492 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A127297CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Traditions Psychiatry Group, P.C Psychiatry CurrentSince Sep 5, 2018 Accepting new patients

Locations

1287 Fulton Rd
Santa Rosa, CA 95401
Phone (707) 543-2031

Interoperability endpoints

  • Direct secure messaging: jdaly118689@santaclaravalley.direct-ci.net

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": "1381449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1174950992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 MERIDIAN AVE STE L #285",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951255586",
            "telephone_number": "831-345-3735",
            "fax_number": "888-377-2923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 W HEDDING ST FL 1",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951101706",
            "telephone_number": "408-808-5299",
            "fax_number": "888-377-2923"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 Allen St, STE B",
            "address_purpose": "LOCATION",
            "city": "Martinez",
            "state": "CA",
            "postal_code": "94553",
            "country_code": "US",
            "telephone_number": "408-364-7069",
            "fax_number": "888-377-2923",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DALY",
        "first_name": "JOHN",
        "middle_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-11",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A127297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.