Individual provider Active NPI

Jamie Ro, PA-C

  • Physician Assistant
  • Fremont, CA
National Provider Identifier
1205169570
Registry record updated Sep 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA53413 Issued in CA
Practice address
39650 Liberty St.
Ste #300, FL3
Fremont, CA 94538-2227
Phone
(510) 498-2689
NPI assigned
Sep 17, 2009
Last updated
Sep 14, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA53413 CA Primary
Registered Dietitian 133V00000X

Addresses

Primary practice location

39650 Liberty St.
Ste #300, FL3
Fremont, CA 94538-2227

Mailing address

2350 W. El Camino Real
2ND Floor
Mounatin View, CA 94040-6203

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160922001919 CA Practitioner - Physician Assistant 5294022042 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

3200 Kearney St
Fremont, CA 94538-2299
Phone (510) 490-1222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA53413CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation CurrentSince Aug 29, 2016 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Aug 29, 2016 Accepting new patients
Sutter East Bay Medical Foundation Past Accepting new patients

Locations

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

39650 Liberty St
Ste 300
Fremont, CA 94538
Phone (510) 498-2689

370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200

2350 W El Camino Real
Fl 2
Mountain View, CA 94040
Phone (650) 691-6174

795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832

795 El Camino Real
#1112
Palo Alto, CA 94301

123 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 343-4200

550 S Green Valley Rd
Watsonville, CA 95076
Phone (831) 458-5865

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1253145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473811200000",
    "number": "1205169570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 W. EL CAMINO REAL",
            "address_2": "2ND FLOOR",
            "city": "MOUNATIN VIEW",
            "state": "CA",
            "postal_code": "940406203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39650 LIBERTY ST.",
            "address_2": "STE #300, FL3",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945382227",
            "telephone_number": "510-498-2689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RO",
        "first_name": "JAMIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-17",
        "last_updated": "2016-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA53413",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

Verify at the official NPI Registry.