NPIMap

Individual provider Active NPI

Jodie Konigsberg, PA-C

  • Surgical Physician Assistant
  • Pleasanton, CA
National Provider Identifier
1437387438
Registry record updated Jun 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA20386 Issued in CA
Practice address
5725 W Las Positas Blvd
Suite 200
Pleasanton, CA 94588-4054
Phone
(925) 469-6274
Fax
(925) 924-1769
NPI assigned
Jun 29, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA20386 CA Primary

Addresses

Primary practice location

5725 W Las Positas Blvd
Suite 200
Pleasanton, CA 94588-4054

Mailing address

5725 W Las Positas Blvd
Suite 200
Pleasanton, CA 94588-4054
Phone (925) 469-6274

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090902000623 CA Practitioner - Physician Assistant 8921153578 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sonora Community HospitalGroup PAC ID 4284538505, 134 clinicians

Practice addresses (Care Compare)

1000 Greenley Rd
Sonora, CA 95370-5200
Phone (209) 536-5000

200 W Roseburg Ave
Suite B1
Modesto, CA 95350-5200
Phone (209) 536-5776

680 Guzzi LN
Sonora, CA 95370-5288

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.77 of 100Reported as apm
Quality
81.54
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
84.78 of 100Reported as group
Quality
81.74
Promoting interoperability
97
Improvement activities
40
Cost
67.27

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20386CAMDAcupuncturist
PA20386CAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sonora Community Hospital CurrentSince Aug 1, 2020 Accepting new patients
Adventist Health Physicians Network CurrentSince May 1, 2019 Accepting new patients
Adventist Health Physicians Network CurrentSince May 1, 2019 Accepting new patients
Sonora Community Hospital Past Accepting new patients

Locations

1524 W Lacey Blvd
Ste 101
Hanford, CA 93230
Phone (559) 583-4695

200 W Roseburg Ave
Ste B1
Modesto, CA 95350
Phone (209) 491-2500

5725 W Las Positas Blvd
Ste 200
Pleasanton, CA 94588
Phone (925) 469-3120

1000 Greenley Rd
Sonora, CA 95370
Phone (209) 263-0803

680 Guzzi Ln
Ste 106
Sonora, CA 95370
Phone (209) 532-2792

680 Guzzi Ln
Ste 201
Sonora, CA 95370
Phone (209) 536-1785

900 Greenley Rd
Ste 914
Sonora, CA 95370
Phone (209) 532-6128

Organizations & group practices 6

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1246233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246233600000",
    "number": "1437387438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5725 W LAS POSITAS BLVD",
            "address_2": "SUITE 200",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945884054",
            "telephone_number": "925-469-6274",
            "fax_number": "925-924-1769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5725 W LAS POSITAS BLVD",
            "address_2": "SUITE 200",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945884054",
            "telephone_number": "925-469-6274",
            "fax_number": "925-924-1769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONIGSBERG",
        "first_name": "JODIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-29",
        "last_updated": "2009-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA20386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasanton, CA

Sources for this page

Verify at the official NPI Registry.