Jay Samuel Joseph, M.D.

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

G74799 Issued in CA

Practice address

1165 S Dora St BLDG H
Ukiah, CA 95482-8325

Phone

(707) 463-3636

Fax

(707) 463-2714

NPI assigned

Oct 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 2

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

Radiation Oncology

Education

University of California, San Diego School of Medicine, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Santa Rosa Memorial Hospital Hospital, Santa Rosa, CA, CCN 050174
• Adventist Health Ukiah Valley Hospital, Ukiah, CA, CCN 050301
• Adventist Health Clearlake Hospital, Clearlake, CA, CCN 051317
• Sutter Lakeside Hospital Hospital, Lakeport, CA, CCN 051329
• Adventist Health Mendocino Coast Hospital, Fort Bragg, CA, CCN 051325

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jay.joseph@stjoe.direct.varian.com

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.

• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  Medicare reassignment Care Compare group NPD (past)
• Providence Medical Foundation

  • Obstetrics & Gynecology Physician
  • Napa, CA
  • NPI 1205131950
  NPD
• Providence Medical Foundation

  • General Practice Physician
  • Diamond Bar, CA
  • NPI 1285890624
  NPD
• Providence Medical Foundation

  • Family Medicine Physician
  • Anaheim, CA
  • NPI 1639715709
  NPD
• Annadel Medical Group, Inc

  • Pediatrics Physician
  • Santa Rosa, CA
  • NPI 1114177425
  NPD (past)
• Providence Medical Foundation

  • Family Medicine Physician
  • Anaheim, CA
  • NPI 1609925957
  NPD (past)
• St. Joseph Health Northern California, LLC

  dba Providence Santa Rosa Memorial Hospital

  • General Acute Care Hospital
  • Santa Rosa, CA
  • NPI 1134152549
  NPD (past)
• Ukiah Adventist Hospital

  dba Adventist Health Ukiah Valley

  • General Acute Care Hospital
  • Ukiah, CA
  • NPI 1235120676
  NPD (past)

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

• Adventist Health Clearlake Hospital Inc.

  dba Adventist Health Clear Lake

  • Critical Access Hospital
  • Clearlake, CA
  • NPI 1124018031
  Care Compare affiliation
• Adventist Health Mendocino Coast

  dba Mendocino Coast District Hospital

  • Critical Access Hospital
  • Fort Bragg, CA
  • NPI 1538113725
  Care Compare affiliation
• St. Joseph Health Northern California, LLC

  dba Providence Santa Rosa Memorial Hospital

  • General Acute Care Hospital
  • Santa Rosa, CA
  • NPI 1134152549
  Care Compare affiliation
• Sutter Bay Hospitals

  • Critical Access Hospital
  • Lakeport, CA
  • NPI 1952634008
  Care Compare affiliation
• Ukiah Adventist Hospital

  dba Adventist Health Ukiah Valley

  • General Acute Care Hospital
  • Ukiah, CA
  • NPI 1235120676
  Care Compare affiliation

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635897600000",
    "number": "1396835153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1165 S DORA ST BLDG H",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954828325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1165 S DORA ST BLDG H",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954828325",
            "telephone_number": "707-463-3636",
            "fax_number": "707-463-2714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSEPH",
        "first_name": "JAY",
        "middle_name": "SAMUEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0203X",
            "taxonomy_group": "",
            "desc": "Radiology, Therapeutic Radiology",
            "state": "CA",
            "license": "G74799",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "CA",
            "license": "G74799",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G747990",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jjoseph1657865@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1165 S Dora St Bldg H",
            "city": "Ukiah",
            "state": "CA",
            "country_code": "US",
            "postal_code": "954828325",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jjoseph1657865@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "121 Sotoyome St",
            "city": "Santa Rosa",
            "state": "CA",
            "country_code": "US",
            "postal_code": "954054823",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Marissa Christine Jones
• Serena Anne Jones, L.C.S.W.
• Tonya Jones
• Treavor Jones
• Evita Joseph, MD
• Juliann Elizabeth Joseph, CNM/ WHNP-BC
• Monica Joseph, DO
• Kirsten Quitno Juliet, M.D.
• Michael Jung, MD
• Thomas Jutzy, D.D.S.

• Radiation Oncology Physician in Ukiah, CA
• Providers in Ukiah, CA by specialty
• Radiation Oncology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.