Individual provider Active NPI

Katherine Jimenez, P.A.

  • Medical Physician Assistant
  • Monterey, CA
National Provider Identifier
1417100769
Registry record updated May 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
19412 Issued in CA
Practice address
12 Upper Ragsdale Dr
Monterey, CA 93940
Phone
(831) 648-7200
Fax
(831) 648-7204
NPI assigned
Oct 30, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 19412 CA Primary

Addresses

Primary practice location

12 Upper Ragsdale Dr
Monterey, CA 93940

Mailing address

12 Upper Ragsdale Dr
Monterey, CA 93940-5730
Phone (831) 648-7200

Other practice location 1

19 Upper Ragsdale Dr
#150
Monterey, CA 93940-7881
Phone (831) 648-8600

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141013000341 CA Practitioner - Physician Assistant 3779715768 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
19412CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Monterey Spine & Joint PC CurrentSince Oct 12, 2014 Accepting new patients
Montage Surgical Group Past Accepting new patients

Locations

12 Upper Ragsdale Dr
Monterey, CA 93940
Phone (831) 264-6060

21 Lower Ragsdale Dr
Monterey, CA 93940
Phone (831) 264-6040

Interoperability endpoints

  • Direct secure messaging: katherine.jimenez.p1@direct.msjhealth.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

NPI Registry JSON

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

{
    "created_epoch": "1225324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526256000000",
    "number": "1417100769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 UPPER RAGSDALE DR",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939405730",
            "telephone_number": "831-648-7200",
            "fax_number": "831-648-7204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 UPPER RAGSDALE DR",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "93940",
            "telephone_number": "831-648-7200",
            "fax_number": "831-648-7204"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19 Upper Ragsdale Dr",
            "address_2": "#150",
            "address_purpose": "LOCATION",
            "city": "Monterey",
            "state": "CA",
            "postal_code": "939407881",
            "country_code": "US",
            "telephone_number": "831-648-8600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "KATHERINE",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-30",
        "last_updated": "2018-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "19412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey, CA

Sources for this page

Verify at the official NPI Registry.