Individual provider Active NPI

Guangjing Zhu, MD, PHD

  • Anatomic Pathology & Clinical Pathology Physician
  • Baltimore, MD
National Provider Identifier
1407378607
Registry record updated Apr 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
190089 Issued in CA
Practice address
22 S Greene St
Baltimore, MD 21201-1544
Phone
(410) 328-5555
NPI assigned
Jul 10, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 314174 NY
Student in an Organized Health Care Education/Training Program 390200000X
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 190089 CA Primary

Addresses

Primary practice location

22 S Greene St
Baltimore, MD 21201-1544

Mailing address

99 Montecillo Rd RM 283
San Rafael, CA 94903-3308
Phone (415) 444-2081

Other practice location 1

1000 10th Ave
First Floor, Room G163a
New York, NY 10019-1147
Phone (212) 523-8652 ext. 23865

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220914001395 NY Practitioner - PathologyPractitioner - Dermatology 5991180754 Reassigns benefits to 2 organizations
I20240402000720 CA Practitioner - Pathology 5991180754 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
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)

99 Montecillo Rd
San Rafael, CA 94903-3308
Phone (415) 444-2000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
190089CAMDAnatomic Pathology & Clinical Pathology Physician
314174NYMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fpa Hospital Based Anatomic Pathology & Clinical Pathology CurrentSince Jul 1, 2022 Accepting new patients
Fpa Hospital Based Anatomic Pathology & Clinical Pathology Current Accepting new patients
Permanente Medical Group Inc Anatomic Pathology & Clinical Pathology Current Accepting new patients
Permanente Medical Group Inc Anatomic Pathology & Clinical Pathology CurrentSince Mar 25, 2024 Accepting new patients
Fpa Hospital Based Current Accepting new patients
Fpa Hospital Based CurrentSince Jul 1, 2022 Accepting new patients
Icahn School of Medicine at Mount Sinai Anatomic Pathology & Clinical Pathology CurrentSince Apr 1, 2023 Accepting new patients
Permanente Medical Group, Inc CurrentSince Mar 25, 2024 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Apr 1, 2023 Accepting new patients

Locations

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

501 J St
Sacramento, CA 95814
Phone (916) 497-3000

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

99 Montecillo Rd
San Rafael, CA 94903
Phone (415) 444-2047

99 Montecillo Rd
Rm 283
San Rafael, CA 94903

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834

5 E 98th St
Fl 6
New York, NY 10029
Phone (212) 241-2221

5 E 98th St
Fl 5
New York, NY 10029
Phone (212) 241-8234

1468 Madison Ave
New York, NY 10029
Phone (212) 241-0440

1000 10th Ave
Fl First
New York, NY 10019
Phone 2125238652 ext. 23865

Organizations & group practices 9

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": "1499644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1407378607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 MONTECILLO RD RM 283",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949033308",
            "telephone_number": "415-444-2081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "410-328-5555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 10th Ave",
            "address_2": "First Floor, Room G163a",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100191147",
            "country_code": "US",
            "telephone_number": "212-523-8652 x23865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZHU",
        "first_name": "GUANGJING",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-10",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NY",
            "license": "314174",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "190089",
            "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": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "99 Montecillo Rd Rm 283",
            "city": "San Rafael",
            "state": "CA",
            "country_code": "US",
            "postal_code": "949033308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.