Individual provider Active NPI

Charu Bahuguna, NP

  • Family Nurse Practitioner
  • San Jose, CA
National Provider Identifier
1447314828
Registry record updated Jan 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
455409 AND 9934 Issued in CA
Practice address
280 Hospital Pkwy
Suite C
San Jose, CA 95119-1103
Phone
(408) 972-7647
Fax
(408) 972-3455
NPI assigned
Dec 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 455409 AND 9934 CA Primary

Addresses

Primary practice location

280 Hospital Pkwy
Suite C
San Jose, CA 95119-1103

Mailing address

825 Figwood CT
San Jose, CA 95120-3313
Phone (408) 972-7647

Electronic endpoints 1

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

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
I20040707000634 CA Practitioner - Nurse Practitioner 7113904152 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

260 International Cir
San Jose, CA 95119-1130
Phone (408) 972-3000

270 International Cir
San Jose, CA 95119-1130
Phone (408) 972-3000

274 International Cir
San Jose, CA 95119-1130
Phone (408) 972-3000

276 International Cir
San Jose, CA 95119-1130
Phone (408) 972-6931

700 Lawrence Expy
Santa Clara, CA 95051-5173
Phone (408) 851-1000

710 Lawrence Express Way
Santa Clara, CA 95051-5173
Phone (408) 851-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
455409 AND 9934CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group, Inc CurrentSince Apr 28, 2011 Accepting new patients
Permanente Medical Group Inc CurrentSince Apr 28, 2011 Accepting new patients

Locations

260 International Cir
Ofc
San Jose, CA 95119

280 Hospital Pkwy
Ste C
San Jose, CA 95119
Phone (408) 972-7647

260 International Cir
San Jose, CA 95119
Phone (408) 972-6335

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

Organizations & group practices 2

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": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1447314828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 FIGWOOD CT",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951203313",
            "telephone_number": "408-972-7647",
            "fax_number": "408-972-3411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 HOSPITAL PKWY",
            "address_2": "SUITE C",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951191103",
            "telephone_number": "408-972-7647",
            "fax_number": "408-972-3455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAHUGUNA",
        "first_name": "CHARU",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-20",
        "last_updated": "2022-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "455409 AND 9934",
            "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": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "260 International Cir",
            "city": "San Jose",
            "state": "CA",
            "country_code": "US",
            "postal_code": "951191130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.