Individual provider Active NPI

Joann Laiprasert-Tantisira

  • Obstetrics & Gynecology Physician
  • San Jose, CA
National Provider Identifier
1336230952
Registry record updated Dec 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A89664 Issued in CA
Practice address
751 S Bascom Ave
Dept. of OBGYN
San Jose, CA 95128-2604
Phone
(408) 885-5552
NPI assigned
Sep 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X A89664 CA Primary

Addresses

Primary practice location

751 S Bascom Ave
Dept. of OBGYN
San Jose, CA 95128-2604

Mailing address

751 S Bascom Ave
Dept. of OBGYN
San Jose, CA 95128-2604
Phone (408) 885-5552

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

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
I20050930000483 CA Practitioner - Obstetrics/Gynecology 7012942782 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Warren Alpert Medical School of Brown University, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

395 Hickey Blvd
Daly City, CA 94015-2770
Phone (650) 301-5860

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
89664CAMDPharmacist
A89664CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc Obstetrics & Gynecology Current Accepting new patients
Permanente Medical Group Inc Obstetrics & Gynecology CurrentSince Dec 17, 2016 Accepting new patients
Permanente Medical Group, Inc CurrentSince Dec 17, 2016 Accepting new patients

Locations

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

395 Hickey Blvd
Daly City, CA 94015
Phone (650) 301-5800

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1336230952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 S BASCOM AVE",
            "address_2": "DEPT. OF OBGYN",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282604",
            "telephone_number": "408-885-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 S BASCOM AVE",
            "address_2": "DEPT. OF OBGYN",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282604",
            "telephone_number": "408-885-5552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAIPRASERT-TANTISIRA",
        "first_name": "JOANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A89664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "395 Hickey Blvd",
            "city": "Daly City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "940152770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.