Individual provider Active NPI

Jessy Joseph

  • Psychiatry Physician
  • Modesto, CA
National Provider Identifier
1457768764
Registry record updated Aug 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A171516 Issued in CA
Practice address
1601 Cummins Dr Ste D
Modesto, CA 95358-6411
Phone
(510) 900-3125
NPI assigned
Jul 18, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X A171516 CA Primary

Addresses

Primary practice location

1601 Cummins Dr Ste D
Modesto, CA 95358-6411

Mailing address

1601 Cummins Dr Ste D
Modesto, CA 95358-6411
Phone (510) 900-3125

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190614002056 NY Practitioner - Psychiatry 3072846526 Reassigns benefits to 2 organizations
I20210722003730 CA Practitioner - Psychiatry 3072846526 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A171516CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Medical Practice Plan PC CurrentSince Jul 1, 2019 Accepting new patients
Cep America - Psychiatry PC Psychiatry CurrentSince Aug 1, 2021 Accepting new patients
Physician Affiliate Group of New York PC CurrentSince Mar 1, 2024 Accepting new patients
Cep America - Psychiatry PC Psychiatry CurrentSince Aug 1, 2021 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1441 Constitution Blvd
Salinas, CA 93906
Phone (831) 261-8090

1400 E Church St
Santa Maria, CA 93454
Phone (805) 739-3000

2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354

1901 1st Ave
New York, NY 10029
Phone (212) 230-6262

506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: jjoseph991760@nychhc.direct-ci.com

Organizations & group practices 4

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": "1405641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1457768764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 CUMMINS DR STE D",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953586411",
            "telephone_number": "510-900-3125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 CUMMINS DR STE D",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953586411",
            "telephone_number": "510-900-3125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSEPH",
        "first_name": "JESSY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-18",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A171516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.