Active NPI
Jason I Lifshutz, MD
- Neurological Surgery Physician
- San Jose, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurological Surgery Physician
- License
- A66442
- Practice address
- 751 S Bascom Ave
Neurosurgery Dept
San Jose, CA 95128-2604 - Phone
- (408) 885-5000
- NPI assigned
- Oct 25, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurological Surgery Physician | 207T00000X | A66442 | CA | Primary |
Addresses
Primary practice location
751 S Bascom Ave
Neurosurgery Dept
San Jose, CA 95128-2604
Mailing address
751 S Bascom Ave
San Jose, CA 95128-2604
Phone (408) 885-5000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A664420 | Medicaid | CA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq | Health Information Exchange (HIE) | Northwest Permanente PC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR, WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Neurosurgery
- Education
- University of Miami, LM Miller School of Medicine, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
10100 SE Sunnyside Rd
Clackamas, OR 97015-8970
Phone (800) 813-2000
10180 SE Sunnyside Rd
Clackamas, OR 97015-8970
Phone (800) 813-2000
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Spinal fusion | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A66442 | CA | MD | Neurological Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaiser Foundation Health Plan of the Northwest | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of the Northwest | Current | Accepting new patients | |
| LPCH Medical Group Div of Lucile | Past | Accepting new patients | |
| University of Maryland Neurosurgery Associates P a | Neurological Surgery | Past | Accepting new patients |
| Kaiser Foundation Hospitals | Past | Accepting new patients |
Locations
10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946
7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051
2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400
1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801
7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000
Organizations & group practices 5
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.
-
- General Practice Physician
- Portland, OR
- NPI 1184786527
WA
-
- Clinic/Center
- Hillsboro, OR
- NPI 1942718622
-
dba Lucile Salter Packard Children's Hospital at Stanford
- Children's Hospital
- Palo Alto, CA
- NPI 1417907940
-
dba Kaiser Sunnyside Medical Center
- General Acute Care Hospital
- Clackamas, OR
- NPI 1124182902
-
- Neurological Surgery Physician
- Columbia, MD
- NPI 1639119035
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Kaiser Sunnyside Medical Center
- General Acute Care Hospital
- Clackamas, OR
- NPI 1124182902
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643932800000",
"number": "1215011960",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "751 S BASCOM AVE",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951282604",
"telephone_number": "408-885-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "751 S BASCOM AVE",
"address_2": "NEUROSURGERY DEPT",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951282604",
"telephone_number": "408-885-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIFSHUTZ",
"first_name": "JASON",
"middle_name": "I",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-25",
"last_updated": "2022-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": "CA",
"license": "A66442",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A664420",
"state": "CA"
}
],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Northwest Permanente PC",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "10100 SE Sunnyside Rd",
"city": "Clackamas",
"state": "OR",
"country_code": "US",
"postal_code": "970158970",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 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.