Individual provider Active NPI

Jessica Hsueh, MD

  • Pediatrics Physician
  • Palo Alto, CA
National Provider Identifier
1447624259
Registry record updated Nov 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036.160306 Issued in IL
Practice address
770 Welch Rd Ste 435
Palo Alto, CA 94304-1511
Phone
(650) 721-4339
NPI assigned
Nov 17, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 036.160306 IL Primary
Internal Medicine Physician 207R00000X 036.160306 IL

Addresses

Primary practice location

770 Welch Rd Ste 435
Palo Alto, CA 94304-1511

Mailing address

840 S Wood St # Mc856
Chicago, IL 60612-4325

Other practice location 1

4440 W 95th St Ste 2177H
Oak Lawn, IL 60453-2600
Phone (708) 684-5341

Other practice location 2

1740 W Taylor St
Chicago, IL 60612-7232
Phone (312) 503-7975

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231031002340 IL Practitioner - Internal MedicinePractitioner - Pediatric Medicine 6305178583 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.160306ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois Current Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Oct 3, 2023 Accepting new patients
The Board of Trustees of the University of Illinois Pediatrics CurrentSince Oct 3, 2023 Accepting new patients

Locations

1740 W Taylor St
#931
Chicago, IL 60612
Phone (312) 355-5258

845 W Wilson Ave
Chicago, IL 60640
Phone (312) 744-1295

840 S Wood St
#856
Chicago, IL 60612
Phone (312) 413-1429

1740 W Taylor St
Chicago, IL 60612
Phone (312) 355-4000

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-6290

4440 W 95th St
Ste 2177H
Oak Lawn, IL 60453
Phone (708) 684-5341

4440 W 95th St
Oak Lawn, IL 60453
Phone (708) 346-5520

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": "1447718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732665600000",
    "number": "1447624259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 S WOOD ST # MC856",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 WELCH RD STE 435",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041511",
            "telephone_number": "650-721-4339"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4440 W 95th St Ste 2177H",
            "address_purpose": "LOCATION",
            "city": "Oak Lawn",
            "state": "IL",
            "postal_code": "604532600",
            "country_code": "US",
            "telephone_number": "708-684-5341",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1740 W Taylor St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606127232",
            "country_code": "US",
            "telephone_number": "312-503-7975",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HSUEH",
        "first_name": "JESSICA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-17",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036.160306",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.160306",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

Verify at the official NPI Registry.