Individual provider Active NPI

Jay William Zimmerman, M.D.

  • Dermatology Physician
  • Walnut Creek, CA
National Provider Identifier
1396789731
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
A5124 Issued in CA
Practice address
2255 Ygnacio Valley Rd Ste B1
Walnut Creek, CA 94598-3335
Phone
(925) 945-7005
Fax
(925) 236-2784
NPI assigned
Jun 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X A5124 CA Primary

Addresses

Primary practice location

2255 Ygnacio Valley Rd Ste B1
Walnut Creek, CA 94598-3335

Mailing address

2255 Ygnacio Valley Rd Ste B1
Walnut Creek, CA 94598-3335
Phone (925) 945-7005

Other practice location 1

1200 Central Blvd Ste D
Brentwood, CA 94513-2227
Phone (925) 308-9510

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
I20061003000755 CA Practitioner - Dermatology 3375548944 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Chicago, Pritzker School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

410 E Yosemite Ave
Suite C
Merced, CA 95340-8220
Phone (209) 722-7801

Merit-based Incentive Payment System (MIPS)

Final score
99.15 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision40
Removal of skin lesions2272
Removal or shaving of skin growth321
Skin biopsy68

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A5124CAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Golden State Dermatology Associates, Inc. Dermatology CurrentSince Mar 1, 2019 Accepting new patients
University of California SFGH Medical Group CurrentSince Jul 1, 2010 Accepting new patients
University of California SFGH Medical Group Dermatology CurrentSince Jul 1, 2010 Accepting new patients
Golden State Dermatology Associates, Inc. CurrentSince Mar 1, 2019 Accepting new patients
California Pacific Medical Group, Inc. Past Accepting new patients

Locations

1200 Central Blvd
Ste D
Brentwood, CA 94513
Phone (925) 308-9510

410 E Yosemite Ave
Ste C
Merced, CA 95340
Phone (209) 205-2999

995 Potrero Ave
Bldg 90
San Francisco, CA 94110
Phone (628) 206-4777

370 N Wiget Ln
Ste 250
Walnut Creek, CA 94598
Phone (925) 278-7592

355 Lennon Ln
Ste 255
Walnut Creek, CA 94598
Phone (925) 932-7704

2255 Ygnacio Valley Rd
Ste B1
Walnut Creek, CA 94598
Phone (925) 945-7005

Organizations & group practices 5

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": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1396789731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2255 YGNACIO VALLEY RD STE B1",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983335",
            "telephone_number": "925-945-7005",
            "fax_number": "925-236-2784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2255 YGNACIO VALLEY RD STE B1",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983335",
            "telephone_number": "925-945-7005",
            "fax_number": "925-236-2784"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 Central Blvd Ste D",
            "address_purpose": "LOCATION",
            "city": "Brentwood",
            "state": "CA",
            "postal_code": "945132227",
            "country_code": "US",
            "telephone_number": "925-308-9510",
            "fax_number": "925-626-7968",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "JAY",
        "middle_name": "WILLIAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A5124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

Verify at the official NPI Registry.