Active NPI
Bruce W. Jensen, M.D.
- Family Medicine Physician
- Citrus Heights, CA
National Provider Identifier
1235230517
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- C36236
- Practice address
- 8001 Madison Ave
Citrus Heights, CA 95610-7901 - Phone
- (916) 536-2400
- NPI assigned
- Sep 26, 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | C36236 | CA | Primary |
Addresses
Primary practice location
8001 Madison Ave
Citrus Heights, CA 95610-7901
Mailing address
3400 Data Dr
Rancho Cordova, CA 95670-7956
Other identifiers 12
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00C362360 | Medicaid | CA | |
| 00C362360 | Other | CA | BLUE SHIELD |
| 13820 | Other | CA | FIRST HEALTH |
| 3170839 | Other | CA | CIGNA |
| 000810342990 | Other | CA | PHCS |
| 1089814 | Other | CA | GREAT WEST |
| 9525 | Other | CA | INTERPLAN |
| MCMG127400 | Other | CA | WESTERN HEALTH ADVANTAGE |
| 4066262 | Other | CA | AETNA |
| C36236 | Other | CA | BLUE CROSS |
| 1454451 | Other | CA | UNITED HEALTHCARE |
| 90014858 | Other | CA | PACIFICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36236 | CA | MD | General Practice Dentistry |
| C36236 | CA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328832000000",
"number": "1235230517",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3400 DATA DR",
"city": "RANCHO CORDOVA",
"state": "CA",
"postal_code": "956707956"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8001 MADISON AVE",
"city": "CITRUS HEIGHTS",
"state": "CA",
"postal_code": "956107901",
"telephone_number": "916-536-2400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENSEN",
"first_name": "BRUCE",
"middle_name": "W.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-26",
"last_updated": "2012-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "C36236",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00C362360",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "00C362360",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH",
"identifier": "13820",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "3170839",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHCS",
"identifier": "000810342990",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GREAT WEST",
"identifier": "1089814",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INTERPLAN",
"identifier": "9525",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WESTERN HEALTH ADVANTAGE",
"identifier": "MCMG127400",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4066262",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "C36236",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "1454451",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PACIFICARE",
"identifier": "90014858",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Citrus Heights, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.