NPIMap

Individual provider Active NPI

Jaishree Rajagopalan, MD

  • Cardiovascular Disease Physician
  • Selma, CA
National Provider Identifier
1356340764
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
A85803 Issued in CA
Practice address
2511 Logan St
Selma, CA 93662-3012
Phone
(559) 896-2624
NPI assigned
Jul 18, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
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
Cardiovascular Disease Physician 207RC0000X A85803 CA Primary

Addresses

Primary practice location

2511 Logan St
Selma, CA 93662-3012

Mailing address

2511 Logan St
Selma, CA 93662-3012

Other identifiers 1

IdentifierTypeStateIssuer
00A858030MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151014000961 CA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 6709856040 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospice/Palliative CareAlso: Internal Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of San MateoGroup PAC ID 9032023171, shared by 15 NPIs, 316 clinicians

Practice addresses (Care Compare)

22 W 39TH Ave
Hos316Ms
San Mateo, CA 94403-4364

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

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
85803CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Mateo CurrentSince Sep 1, 2015 Accepting new patients
County of San Mateo CurrentSince Dec 10, 2022 Accepting new patients
County of San Mateo CurrentSince Sep 1, 2015 Accepting new patients
Vitas Health Services of California Inc Past Accepting new patients
Stanley Y. Louie DO, Inc Past Accepting new patients
Central California Faculty Medical Group, Inc. Cardiovascular Disease Past Accepting new patients

Locations

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

Interoperability endpoints

  • Direct secure messaging: jrajagopalan19352@smch.direct-ci.com

Organizations & group practices 6

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 9

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": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356340764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2511 LOGAN ST",
            "city": "SELMA",
            "state": "CA",
            "postal_code": "936623012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2511 LOGAN ST",
            "city": "SELMA",
            "state": "CA",
            "postal_code": "936623012",
            "telephone_number": "559-896-2624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJAGOPALAN",
        "first_name": "JAISHREE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A85803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A858030",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Selma, CA

Sources for this page

Verify at the official NPI Registry.