Individual provider Active NPI

Jason Rose, PA

  • Physician Assistant
  • West Sacramento, CA
National Provider Identifier
1346555620
Registry record updated May 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA21088 Issued in CA
Practice address
500 Jefferson Blvd Ste B180
West Sacramento, CA 95605-2394
Phone
(916) 403-2900
Fax
(530) 204-5248
NPI assigned
Aug 11, 2010
Last updated
May 20, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2020

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 PA21088 CA Primary

Addresses

Primary practice location

500 Jefferson Blvd Ste B180
West Sacramento, CA 95605-2394

Mailing address

500 Jefferson Blvd
Ste B180
West Sacramento, CA 95605-2394
Phone (916) 403-2900

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
I20170531001238 CA Practitioner - Physician Assistant 4880849173 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Enloe Medical CenterGroup PAC ID 9739092388, shared by 18 NPIs, 330 clinicians

Practice addresses (Care Compare)

1531 Esplanade
Chico, CA 95926-3310

1600 Esplanade
Suite C
Chico, CA 95926-3369
Phone (530) 332-4470

888 Lakeside VLG CMNS
Chico, CA 95928-3979
Phone (530) 332-6850

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.49 of 100Reported as group
Quality
60.52
Promoting interoperability
100
Improvement activities
40
Cost
68.7

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Enloe Medical Center CurrentSince Jun 24, 2019 Accepting new patients
Enloe Medical Center CurrentSince Nov 17, 2020 Accepting new patients
Enloe Medical Center CurrentSince Nov 17, 2020 Accepting new patients
Enloe Medical Center CurrentSince Jun 24, 2019 Accepting new patients
Rideout Memorial Hospital Past Accepting new patients

Locations

1390 E Lassen Ave
Chico, CA 95973
Phone (530) 332-6325

1600 Esplanade
Ste C
Chico, CA 95926
Phone (530) 332-4470

888 Lakeside Vlg Cmns
Chico, CA 95928
Phone (530) 332-6800

Interoperability endpoints

  • Direct secure messaging: jrose47866@enloedirect.org

Organizations & group practices 7

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1281484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589932800000",
    "number": "1346555620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 JEFFERSON BLVD",
            "address_2": "STE B180",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "956052394",
            "telephone_number": "916-403-2900",
            "fax_number": "530-204-5248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 JEFFERSON BLVD STE B180",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "956052394",
            "telephone_number": "916-403-2900",
            "fax_number": "530-204-5248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "JASON",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-11",
        "last_updated": "2020-05-20",
        "certification_date": "2020-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA21088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Sacramento, CA

Sources for this page

Verify at the official NPI Registry.