Individual provider Active NPI

Jessica K Chu, PA

  • Physician Assistant
  • San Mateo, CA
National Provider Identifier
1306257167
Registry record updated May 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
51601 Issued in CA
Practice address
222 W 39TH Ave
San Mateo, CA 94403-4364
Phone
(650) 573-2222
Fax
(650) 573-2214
NPI assigned
May 15, 2014
Last updated
May 15, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 51601 CA Primary

Addresses

Primary practice location

222 W 39TH Ave
San Mateo, CA 94403-4364

Mailing address

222 W 39TH Ave
San Mateo, CA 94403-4364
Phone (650) 573-2222

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141001002827 CA Practitioner - Physician Assistant 9234359894 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
51601CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America-California CurrentSince Jul 1, 2014 Accepting new patients
Cep America - California CurrentSince Jul 1, 2014 Accepting new patients

Locations

170 Alameda de las Pulgas
Redwood City, CA 94062
Phone (650) 367-5536

222 W 39th Ave
San Mateo, CA 94403
Phone (415) 573-2222

Interoperability endpoints

  • Direct secure messaging: jchu21333@smch.direct-ci.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1400112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400112000000",
    "number": "1306257167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 W 39TH AVE",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944034364",
            "telephone_number": "650-573-2222",
            "fax_number": "650-573-2214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 W 39TH AVE",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944034364",
            "telephone_number": "650-573-2222",
            "fax_number": "650-573-2214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHU",
        "first_name": "JESSICA",
        "middle_name": "K",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-15",
        "last_updated": "2014-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "51601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

Verify at the official NPI Registry.