Atif Kidwai Jensen, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

250130 Issued in MA

Practice address

1447 York Rd
Suite 100
Lutherville, MD 21093-6017

Phone

(908) 528-2270

NPI assigned

Apr 17, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

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

Specialty

Nephrology

Education

Other, 2006

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)

Hospital & facility affiliations

• SHC West San Leandro Dialysis facility, San Leandro, CA, CCN 552720
• Kaiser Foundation Hospital - San Leandro Hospital, San Leandro, CA, CCN 050777
• Kaiser Foundation Hospital - Fremont Hospital, Fremont, CA, CCN 050512

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299
  Medicare reassignment Care Compare group NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Satellite Dialysis of West San Leandro LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • San Leandro, CA
  • NPI 1205199460

  Dialysis facility

  Care Compare affiliation Name & address match
• Kaiser Foundation Hospitals

  • General Acute Care Hospital
  • San Leandro, CA
  • NPI 1649605403
  Care Compare affiliation
• Kaiser Foundation Hospitals

  • General Acute Care Hospital
  • Fremont, CA
  • NPI 1801960513
  Care Compare affiliation

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1346465838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1447 YORK RD",
            "address_2": "SUITE 100",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210936017",
            "telephone_number": "908-528-2270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1447 YORK RD",
            "address_2": "SUITE 100",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210936017",
            "telephone_number": "908-528-2270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "ATIF",
        "middle_name": "KIDWAI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-17",
        "last_updated": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "250130",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A108255",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MA",
            "license": "250130",
            "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": "27303 Sleepy Hollow Ave S",
            "city": "Hayward",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945454203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Janice C. C. Lepore, Psy.D., and Associates, LLC
• Akira Shian Jarrett
• Erin Jedlanek, MS, CCC-SLP
• Latai Camile Jenkins, DPT
• Jennifer Raia, LCSW-C, LLC
• Susanna Katherine Jeurling, M.D.
• Jian Zhang
• Anjana Prasad Jindal, M.D.
• JMR Creations LLC
• John M Hyson III D.D.S. P.a.

• Nephrology Physician in Lutherville, MD
• Providers in Lutherville, MD by specialty
• Nephrology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.