Individual provider Active NPI

Jane F. Kardashian, M.D.

  • Dermatology Physician
  • Fresno, CA
National Provider Identifier
1417014036
Registry record updated May 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
G439580 Issued in CA
Practice address
6769 N Fresno St
Fresno, CA 93710-3715
Phone
(559) 435-0337
Fax
(559) 435-2918
NPI assigned
Jan 2, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2013

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 G439580 CA Primary

Addresses

Primary practice location

6769 N Fresno St
Fresno, CA 93710-3715

Mailing address

6769 N Fresno St
Fresno, CA 93710-3715
Phone (559) 435-0337

Other identifiers 1

IdentifierTypeStateIssuer
G439580OtherCASTATE LICENSE NUMBER

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
I20120319000242 CA Practitioner - Dermatology 3072683929 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Rutgers New Jersey Medical School, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

355 Lennon LN
Suite 255
Walnut Creek, CA 94598-2496
Phone (925) 932-7704

6769 N Fresno St
Suite 101
Fresno, CA 93710-3715
Phone (559) 435-0337

Hospital & facility affiliations

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) excision63
Removal of tissue16
Removal of skin lesions1434
Removal of skin cancer112
Removal or shaving of skin growth102
Skin biopsy118

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G439580CAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Golden State Dermatology Associates, Inc. CurrentSince Oct 5, 2020 Accepting new patients
Jane F. Kardashian, M.D., Inc. Dermatology Current Accepting new patients
Golden State Dermatology Associates, Inc. Dermatology CurrentSince Oct 5, 2020 Accepting new patients
Fresno Community Hospital and Medical Center Past Accepting new patients
Saint Agnes Medical Center Past Accepting new patients

Locations

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

6769 N Fresno St
Ste 101
Fresno, CA 93710
Phone (559) 435-0337

6769 N Fresno St
Ste 201
Fresno, CA 93710
Phone (559) 440-1500

6769 N Fresno St
Fresno, CA 93710
Phone (559) 435-0337

6769 N Fresno St
Ste 100
Fresno, CA 93710

388 E Yosemite Ave
Ste 100
Merced, CA 95340
Phone (209) 383-3456

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

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

Interoperability endpoints

  • Direct secure messaging: jkardashian2714504@direct.trinity-health.org

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.

Hospital & facility affiliations 1

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": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367798400000",
    "number": "1417014036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6769 N FRESNO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937103715",
            "telephone_number": "559-435-0337",
            "fax_number": "559-435-2918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6769 N FRESNO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937103715",
            "telephone_number": "559-435-0337",
            "fax_number": "559-435-2918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARDASHIAN",
        "first_name": "JANE",
        "middle_name": "F.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-02",
        "last_updated": "2013-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "G439580",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "G439580",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.