Individual provider Active NPI

Padma Mahajan, MD

  • Family Medicine Physician
  • San Jose, CA
National Provider Identifier
1265547830
Registry record updated Jul 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A36338 Issued in CA
Practice address
2242 Camden Ave Ste 203
San Jose, CA 95124-2029
Phone
(408) 356-7161
Fax
(408) 356-6676
NPI assigned
Aug 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2023

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 A36338 CA Primary

Addresses

Primary practice location

2242 Camden Ave Ste 203
San Jose, CA 95124-2029

Mailing address

2242 Camden Ave Ste 203
San Jose, CA 95124-2029
Phone (408) 356-7161

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100921001286 CA Practitioner - General PracticePractitioner - Family Practice 6406972991 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2516 Samaritan Dr
Suite H
San Jose, CA 95124-4108
Phone (408) 356-7161

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A36338CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Padma Mahajan M.D., Inc CurrentSince May 31, 2010 Accepting new patients
Good Samaritan Hospital, L.P. Past Accepting new patients

Locations

2242 Camden Ave
Ste 203
San Jose, CA 95124
Phone (408) 250-9667

2516 Samaritan Dr
Ste H
San Jose, CA 95124
Phone (408) 356-7161

2577 Samaritan Dr
Ste 855
San Jose, CA 95124
Phone (408) 356-7161

Organizations & group practices 2

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 1

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": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689465600000",
    "number": "1265547830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2242 CAMDEN AVE STE 203",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951242029",
            "telephone_number": "408-356-7161",
            "fax_number": "408-356-6676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2242 CAMDEN AVE STE 203",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951242029",
            "telephone_number": "408-356-7161",
            "fax_number": "408-356-6676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHAJAN",
        "first_name": "PADMA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2023-07-16",
        "certification_date": "2023-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A36338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.