Jelriza Claire B. Mansouri, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

A97750 Issued in CA

Practice address

2299 Mowry Ave
Suite 3-C
Fremont, CA 94538-1621

Phone

(510) 248-1470

Fax

(510) 796-5198

NPI assigned

Feb 2, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jelriza Claire Ilagan Baylosis Other name

Electronic endpoints 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

Obstetrics/Gynecology

Education

Albany Medical College of Union University, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299

  Obstetrics & Gynecology

  Medicare reassignment Care Compare group NPD
• Washington Township Medical Foundation

  • Internal Medicine Physician
  • Fremont, CA
  • NPI 1346557014

  Obstetrics & Gynecology

  Medicare reassignment NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • San Francisco, CA
  • NPI 1841373800

  Obstetrics & Gynecology

  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD
• Washington Township Medical Foundation

  • Urgent Care Clinic/Center
  • Fremont, CA
  • NPI 1669360681
  NPD
• Washington Township Medical Group

  • Family Medicine Physician
  • Fremont, CA
  • NPI 1174675417
  NPD (past)

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1184762015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39141 CIVIC CENTER DR",
            "address_2": "SUITE 220",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945385818",
            "telephone_number": "510-248-1000",
            "fax_number": "510-608-6055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2299 MOWRY AVE",
            "address_2": "SUITE 3-C",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381621",
            "telephone_number": "510-248-1470",
            "fax_number": "510-796-5198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSOURI",
        "first_name": "JELRIZA CLAIRE",
        "middle_name": "B.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-02",
        "last_updated": "2022-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A97750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "200 Muir Rd",
            "city": "Martinez",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945534614",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JELRIZA CLAIRE",
            "last_name": "BAYLOSIS",
            "middle_name": "ILAGAN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ryanne Mann
• Tiffany Mann
• Hannah Thuong Hoai Manoff, ACSW
• Samantha Manrique
• Amal Mansoor, OD
• Madeline Mante, RN
• Jason Robert Cristobal Manuel
• Jee-in Mao
• Leo Mapagu, M.S. CCC-SLP
• Angelo Brian Mapalo

• Obstetrics & Gynecology Physician in Fremont, CA
• Providers in Fremont, CA by specialty
• Obstetrics & Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2022; 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.