Individual provider Active NPI

James Peter Keim, MSW, LCSW

  • Clinical Social Worker
  • San Jose, CA
National Provider Identifier
1326176116
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW-991977 Issued in CO
Practice address
1340 Tully Rd Ste 304
San Jose, CA 95122-3055
Phone
(650) 771-6363
NPI assigned
Mar 1, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW-991977 CO Primary

Addresses

Primary practice location

1340 Tully Rd Ste 304
San Jose, CA 95122-3055

Mailing address

PO Box 7540
Menlo Park, CA 94026-7540
Phone (650) 771-6363

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230220002560 CA Practitioner - Clinical Social Worker 6800072547 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifelong Medical CareGroup PAC ID 2062304538, 75 clinicians

Practice addresses (Care Compare)

10700 Macarthur Blvd
Suite 14B
Oakland, CA 94605-5260
Phone (510) 563-4300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW-991977COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lifelong Medical Care CurrentSince Jan 9, 2023 Accepting new patients
Lifelong Medical Care CurrentSince Jan 9, 2023 Accepting new patients

Locations

2344 6th St
Berkeley, CA 94710
Phone (510) 981-3203

10700 MacArthur Blvd
Ste 14B
Oakland, CA 94605
Phone (510) 563-4300

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, 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": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326176116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7540",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940267540",
            "telephone_number": "650-771-6363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 TULLY RD STE 304",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951223055",
            "telephone_number": "650-771-6363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEIM",
        "first_name": "JAMES",
        "middle_name": "PETER",
        "name_prefix": "Mr.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW-991977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.