Individual provider Active NPI

Vijay K Jain, MD

  • Nephrology Physician
  • Concord, CA
National Provider Identifier
1407938632
Registry record updated Oct 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
C172171 Issued in CA
Practice address
2222 East St Ste 305
Concord, CA 94520-2066
Phone
(925) 686-0315
Fax
(925) 686-8443
NPI assigned
Oct 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X C172171 CA Primary

Addresses

Primary practice location

2222 East St Ste 305
Concord, CA 94520-2066

Mailing address

850 W Rio Salado Pkwy Ste 201
Tempe, AZ 85281-3812
Phone (480) 610-6100

Other identifiers 1

IdentifierTypeStateIssuer
C172171OtherCAMEDICAL LICENSE

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
I20110325000708 NY Practitioner - NephrologyPractitioner - Internal Medicine 7517150824 Reassigns benefits to 1 organization
I20220527000272 CA Practitioner - Nephrology 7517150824 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Coast KidneyGroup PAC ID 1759700149, 56 clinicians

Practice addresses (Care Compare)

2370 Country Hills Dr
Suite 101
Antioch, CA 94509-7436
Phone (925) 779-9635

Hospital & facility affiliations

  • DaVita Antioch Dialysis Center Dialysis facility, Antioch, CA, CCN 052841
  • DaVita Lone Tree Ranch Dialysis Dialysis facility, Antioch, CA, CCN 552829
  • DaVita Walnut Creek Dialysis Center Dialysis facility, Walnut Creek, CA, CCN 052689

Merit-based Incentive Payment System (MIPS)

Final score
96.1 of 100Reported as group
Quality
77.33
Promoting interoperability
99
Improvement activities
40
Cost
77.19

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C172171CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Western New York Medical Practice P.C. CurrentSince Feb 1, 2019 Accepting new patients
California Pacific Medical Group, Inc. Past Accepting new patients

Locations

1561 Long Pond Rd
Ste 302
Rochester, NY 14626
Phone (585) 723-1120

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: vijay.jain.1@8243.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666915200000",
    "number": "1407938632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 W RIO SALADO PKWY STE 201",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852813812",
            "telephone_number": "480-610-6100",
            "fax_number": "480-610-6183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 EAST ST STE 305",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945202066",
            "telephone_number": "925-686-0315",
            "fax_number": "925-686-8443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAIN",
        "first_name": "VIJAY",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2022-10-28",
        "certification_date": "2022-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "C172171",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "C172171",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, CA

Sources for this page

Verify at the official NPI Registry.