Organization Active NPI

Rashmi Jain M D Professional Corporation

  • Nephrology Physician
  • Burlingame, CA
National Provider Identifier
1487834479
Registry record updated Nov 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
C42911 Issued in CA
Legal business name
RASHMI JAIN M D PROFESSIONAL CORPORATION
Practice address
1828 El Camino Real Ste 407
Burlingame, CA 94010-3115
Phone
(650) 777-0050
Fax
(650) 777-0052
NPI assigned
Nov 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2017

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

Authorized official

Name
Dr. Rashmi Jain, MDNPI 1346444577
Title
Doctor
Phone
(650) 777-0050

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X C42911 CA
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X C42911 CA Primary

Addresses

Primary practice location

1828 El Camino Real Ste 407
Burlingame, CA 94010-3115

Mailing address

1828 El Camino Real Ste 407
Burlingame, CA 94010-3115
Phone (650) 777-0050

Other identifiers 1

IdentifierTypeStateIssuer
00C429111MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080126000135 CA Part B Supplier - Clinic/Group Practice 3779665955 Receives reassigned benefits from 1 practitioner
Practice locations: Burlingame, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1194393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511308800000",
    "number": "1487834479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1828 EL CAMINO REAL STE 407",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940103115",
            "telephone_number": "650-777-0050",
            "fax_number": "650-777-0052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1828 EL CAMINO REAL STE 407",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940103115",
            "telephone_number": "650-777-0050",
            "fax_number": "650-777-0052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RASHMI JAIN M D PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-07",
        "last_updated": "2017-11-22",
        "status": "A",
        "authorized_official_last_name": "JAIN",
        "authorized_official_first_name": "RASHMI",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "650-777-0050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C42911",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "C42911",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C429111",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlingame, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.