Active NPI
Jennifer Decolongon, M.D.
- Family Medicine Physician
- Sacramento, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- A127594
- Practice address
- 1020 29TH St
Suite 480
Sacramento, CA 95816-5125 - Phone
- (916) 733-3777
- Fax
- (916) 454-6780
- NPI assigned
- Aug 26, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A127594 | CA | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | PENDING | NY |
Addresses
Primary practice location
1020 29TH St
Suite 480
Sacramento, CA 95816-5125
Mailing address
10470 Old Placerville Rd
Suite 100
Sacramento, CA 95827-2539
Phone (800) 470-0071
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2700 Grant St
Suite 200
Concord, CA 94520-2270
Phone (925) 674-0500
Hospital & facility affiliations
- John Muir Medical Center - Walnut Creek Campus
- John Muir Medical Center - Concord Campus
Merit-based Incentive Payment System (MIPS)
- Final score
- 83.63 of 100
- Quality
- 67.56
- Improvement activities
- 40
- Cost
- 71.56
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.32 of 100
- Quality
- 89.54
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 74.34
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A127594 | CA | MD | Family Medicine Physician |
| PENDING | NY | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| John Muir Physician Network | Current | Accepting new patients | |
| John Muir Trauma Physicians Billing Service | Current | Accepting new patients | |
| John Muir Trauma Physicians Billing Service | Family Medicine | Current | Accepting new patients |
| John Muir Health | Past | Accepting new patients | |
| John Muir Health | Past | Accepting new patients |
Locations
2400 Balfour Rd
Ste 120
Brentwood, CA 94513
Phone (925) 308-8112
2700 Grant St
Ste 200
Concord, CA 94520
Phone (925) 674-2609
2540 East St
Concord, CA 94520
Phone (925) 674-2228
380 Civic Dr
Ste 100
Pleasant Hill, CA 94523
Phone (925) 284-3840
1601 Ygnacio Valley Rd
Walnut Creek, CA 94598
Phone (925) 295-1545
1850 Mt Diablo Blvd
Ste 545
Walnut Creek, CA 94596
Phone (925) 946-1080
Interoperability endpoints
- jdecolongon40948@ehr.johnmuirhealth.com
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
- Walnut Creek, CA
- NPI 1841407665
-
- Hospitalist Physician
- Walnut Creek, CA
- NPI 1093864837
-
- Trauma Surgery Physician
- Walnut Creek, CA
- NPI 1962551861
Family Medicine
-
- Rehabilitation Hospital Unit
- Walnut Creek, CA
- NPI 1447269303
-
- General Acute Care Hospital
- Concord, CA
- NPI 1801821376
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Walnut Creek, CA
- NPI 1740215219
-
- General Acute Care Hospital
- Concord, CA
- NPI 1801821376
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1282780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1387324800000",
"number": "1225344484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10470 OLD PLACERVILLE RD",
"address_2": "SUITE 100",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958272539",
"telephone_number": "800-470-0071"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1020 29TH ST",
"address_2": "SUITE 480",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958165125",
"telephone_number": "916-733-3777",
"fax_number": "916-454-6780"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DECOLONGON",
"first_name": "JENNIFER",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-08-26",
"last_updated": "2013-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "A127594",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NY",
"license": "PENDING",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2013; 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.