NPIMap

Individual provider Active NPI

Wasfa Jabeen Jahangiri, MD

  • Family Medicine Physician
  • Vallejo, CA
National Provider Identifier
1215021175
Registry record updated Feb 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A90365 Issued in CA
Practice address
243 Georgia Street
Ste B
Vallejo, CA 94590
Phone
(707) 556-8100
Fax
(707) 556-8107
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A90365 CA Primary

Addresses

Primary practice location

243 Georgia Street
Ste B
Vallejo, CA 94590

Mailing address

PO Box 22210
Oakland, CA 94623-2210
Phone (510) 535-4000

Other identifiers 1

IdentifierTypeStateIssuer
FHC70543GMedicaidCA

Other names 1

  • Wasfa Jabeen Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050331000276 CA Practitioner - Family Practice 8729035951 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
La Clinica de la Raza IncGroup PAC ID 1557258282, 130 clinicians

Practice addresses (Care Compare)

210 Hospital Dr
Vallejo, CA 94589-2517
Phone (707) 645-7316

220 Hospital Dr
Vallejo, CA 94589-2517
Phone (707) 641-1900

415 Georgia St
Vallejo, CA 94590-6004
Phone (707) 556-8100

Hospital & facility affiliations

  • Sutter Care at Home Home health agency, Concord, CA, CCN 057004
  • Healthflex Home Health Services Home health agency, Oakland, CA, CCN 059551
  • Assist on Call Professional in-Home Care Services Home health agency, Pleasant Hill, CA, CCN 059607
  • Mary'S Help Home Health Services, Inc Home health agency, Vallejo, CA, CCN 059143
  • Sutter Solano Medical Center Hospital, Vallejo, CA, CCN 050101

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A90365CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
La Clinica de la Raza Inc CurrentSince Nov 3, 2009 Accepting new patients
La Clinica de la Raza Inc Current Accepting new patients
La Clinica de la Raza Inc CurrentSince Nov 3, 2009 Accepting new patients

Locations

243 Georgia St
#B
Vallejo, CA 94590
Phone (707) 556-8100

220 Hospital Dr
Vallejo, CA 94589
Phone (707) 641-1900

415 Georgia St
Vallejo, CA 94590
Phone (707) 556-8100

Interoperability endpoints

  • Direct secure messaging: wjahangiri306582@direct.ochin.org

Organizations & group practices 12

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581552000000",
    "number": "1215021175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22210",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946232210",
            "telephone_number": "510-535-4000",
            "fax_number": "510-535-4189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "243 GEORGIA STREET",
            "address_2": "STE B",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "94590",
            "telephone_number": "707-556-8100",
            "fax_number": "707-556-8107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAHANGIRI",
        "first_name": "WASFA",
        "middle_name": "JABEEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A90365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FHC70543G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WASFA",
            "last_name": "JABEEN",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Vallejo, CA

Sources for this page

Verify at the official NPI Registry.