Active NPI
Cornelius J.a. Jansen, MD
- Otolaryngology Physician
- Walnut Creek, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- G85048
- Practice address
- 1425 S Main St
Walnut Creek, CA 94596-5318 - Phone
- (925) 295-4000
- NPI assigned
- Nov 2, 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 |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | G85048 | CA | Primary |
Addresses
Primary practice location
1425 S Main St
Walnut Creek, CA 94596-5318
Mailing address
2390 Faraday Ave
Carlsbad, CA 92008-7216
Phone (510) 625-6262
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G850480 | Medicaid | CA |
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 85048 | CA | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Regents of the University of California - Ucsd Medical Group | Current | Accepting new patients | |
| Regents of the University of California | Current | Accepting new patients | |
| Scripps Health | Current | Accepting new patients | |
| Regents of the University of California | Current | Accepting new patients | |
| Ritvik Mehta, MD Apc | Otolaryngology | Current | Accepting new patients |
Locations
2390 Faraday Ave
Carlsbad, CA 92008
Phone (858) 909-0770
577 Third Ave
Chula Vista, CA 91910
Phone (619) 426-5181
3855 Health Sciences Dr
La Jolla, CA 92093
Phone (858) 822-6094
9350 Campus Point Dr
La Jolla, CA 92037
Phone (858) 657-0583
9300 Campus Point Dr
La Jolla, CA 92037
Phone (619) 957-7000
9400 Campus Point Dr
La Jolla, CA 92093
Phone (858) 249-3800
5405 Oberlin Dr
Fl 2
San Diego, CA 92121
Phone (858) 279-4221
200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754
8899 University Center Ln
San Diego, CA 92122
Phone (858) 543-7496
16950 Via Tazon
San Diego, CA 92127
Phone (858) 521-2265
Interoperability endpoints
- cjansen324414@scrippshlth.medalliesdirect.net
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.
-
- Pain Medicine (Anesthesiology) Physician
- San Diego, CA
- NPI 1376646869
-
- Otolaryngology Physician
- Carlsbad, CA
- NPI 1538302997
-
- Diagnostic Radiology Physician
- San Diego, CA
- NPI 1558463927
-
- Gastroenterology Physician
- San Diego, CA
- NPI 1336267137
-
- General Acute Care Hospital
- San Diego, CA
- NPI 1487928891
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1570752000000",
"number": "1285712380",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2390 FARADAY AVE",
"city": "CARLSBAD",
"state": "CA",
"postal_code": "920087216",
"telephone_number": "510-625-6262"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1425 S MAIN ST",
"city": "WALNUT CREEK",
"state": "CA",
"postal_code": "945965318",
"telephone_number": "925-295-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JANSEN",
"first_name": "CORNELIUS",
"middle_name": "J.A.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-02",
"last_updated": "2019-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "CA",
"license": "G85048",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G850480",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Walnut Creek, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2019; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.