Individual provider Active NPI

Vivian Diep

  • Physician Assistant
  • San Jose, CA
National Provider Identifier
1487167912
Registry record updated Jan 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2690 S White Rd Ste 50
San Jose, CA 95148-2075
Phone
(408) 223-7000
Fax
(408) 223-7001
NPI assigned
Nov 6, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X CA Primary

Addresses

Primary practice location

2690 S White Rd Ste 50
San Jose, CA 95148-2075

Mailing address

751 S Bascom Ave
San Jose, CA 95128-2604

Other practice location 1

751 S Bascom Ave
San Jose, CA 95128-2604
Phone (888) 334-1000

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
I20181108002682 CA Practitioner - Physician Assistant 6002160165 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.53 of 100Reported as group
Quality
87.08
Promoting interoperability
100
Improvement activities
40
Cost
69.51

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55449CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
County of Santa Clara CurrentSince Aug 27, 2018 Accepting new patients
County of Santa Clara CurrentSince Aug 27, 2018 Accepting new patients
Stanford Health Care CurrentSince Nov 13, 2020 Accepting new patients
Stanford Health Care CurrentSince Nov 13, 2020 Accepting new patients

Locations

7999 Gateway Blvd
Ste 200
Newark, CA 94560
Phone (510) 806-2947

2690 S White Rd
Ste 50
San Jose, CA 95148
Phone (408) 223-7000

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

300 Pasteur Dr
Stanford, CA 94305
Phone (650) 498-5710

Interoperability endpoints

  • Direct secure messaging: vdiep89871@santaclaravalley.direct-ci.net

Organizations & group practices 7

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": "1509926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579046400000",
    "number": "1487167912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 S BASCOM AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2690 S WHITE RD STE 50",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951482075",
            "telephone_number": "408-223-7000",
            "fax_number": "408-223-7001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "751 S Bascom Ave",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951282604",
            "country_code": "US",
            "telephone_number": "888-334-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIEP",
        "first_name": "VIVIAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-06",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.