Organization Active NPI

Shen Medicine & Pediatrics Associates a Professional Corporation

  • Multi-Specialty Clinic/Center
  • San Jose, CA
National Provider Identifier
1285662270
Registry record updated Jul 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
License
A54917 Issued in CA
Legal business name
SHEN MEDICINE & PEDIATRICS ASSOCIATES A PROFESSIONAL CORPORATION
Practice address
316 Rosewood Ave
San Jose, CA 95117-1605
Phone
(408) 296-9800
NPI assigned
Jun 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2007

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

Authorized official

Name
Dr. Al Shen, MD
Title
President
Phone
(408) 296-9800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X A54917 CA Primary

Addresses

Primary practice location

316 Rosewood Ave
San Jose, CA 95117-1605

Mailing address

316 Rosewood Ave
San Jose, CA 95117-1605
Phone (408) 296-9800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071130000170 CA Part B Supplier - Clinic/Group Practice 7012006950 Receives reassigned benefits from 1 practitioner
Practice locations: San Jose, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184716800000",
    "number": "1285662270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 ROSEWOOD AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951171605",
            "telephone_number": "408-296-9800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 ROSEWOOD AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951171605",
            "telephone_number": "408-296-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHEN MEDICINE & PEDIATRICS ASSOCIATES A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-29",
        "last_updated": "2007-07-18",
        "status": "A",
        "authorized_official_last_name": "SHEN",
        "authorized_official_first_name": "AL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "408-296-9800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "CA",
            "license": "A54917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.