Jason Andrade

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

20A17796 Issued in CA

Practice address

1528 Eureka Rd Ste 103
Roseville, CA 95661-3047

Phone

(916) 772-5325

NPI assigned

Apr 15, 2018

Last updated

Nov 4, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in CO, CA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Interventional Pain Management

Education

Touro Un College of Osteopathic Medicine, Vallejo, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Spine and Nerve Diagnostic CenterGroup PAC ID 9830416460, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jandrade696429@hisp.ehr.sutterhealth.org

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.

• Spine & Nerve Diagnostic Center

  • Physical Medicine & Rehabilitation Physician
  • Roseville, CA
  • NPI 1144628504
  Medicare reassignment Care Compare group NPD
• Spine West a Professional LLC

  • Physical Medicine & Rehabilitation Physician
  • Boulder, CO
  • NPI 1427091206
  Medicare reassignment NPD
• Spine & Nerve Diagnostic Center

  • Physical Medicine & Rehabilitation Physician
  • Folsom, CA
  • NPI 1457902496
  NPD
• Spine West a Professional LLC

  • Physical Medicine & Rehabilitation Physician
  • Wheat Ridge, CO
  • NPI 1780298307
  NPD
• Spine & Nerve Diagnostic Center

  • Physical Medicine & Rehabilitation Physician
  • Sacramento, CA
  • NPI 1750789053
  NPD (past)
• Spine & Nerve Diagnostic Center

  • Physical Medicine & Rehabilitation Physician
  • Elk Grove, CA
  • NPI 1952770919
  NPD (past)
• Diversified Radiology of Colorado, Inc

  • Diagnostic Radiology Physician
  • Lakewood, CO
  • NPI 1205923596
  NPD (past)

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

{
    "created_epoch": "1523750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1245727304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W MINERAL KING AVE",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932916237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1528 EUREKA RD STE 103",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613047",
            "telephone_number": "916-772-5325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDRADE",
        "first_name": "JASON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-15",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CO",
            "license": "DR.0068543",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "20A17796",
            "primary": true
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "CO",
            "license": "DR.0068543",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "CO",
            "license": "DR.0068543",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kreston Anderson, DDS
• Laura Elizabeth Anderson, O.D.
• Tyrell Anderson
• Yvette Anderson
• Hannah Andosca
• Andrea Conner Marriage and Family Therapy Corp
• Andrek Rosortho Ingersoll Dental Corporation
• Andrew Kelada MD (Roseville Pulmonary Healthcare)
• Andrew R. Demar,Jr,M.D. Inc
• Andrew Scott Chiropractic, Inc.

• Physical Medicine & Rehabilitation Physician in Roseville, CA
• Providers in Roseville, CA by specialty
• Physical Medicine & Rehabilitation Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; 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.

Verify at the official NPI Registry.