Individual provider Active NPI

Jessica Rea

  • Vascular Surgery Physician
  • Oakland, CA
National Provider Identifier
1497173975
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
D98294 Issued in MD
Practice address
1411 E 31St St
Qic 22134
Oakland, CA 94602-1018
Phone
(510) 437-4800
NPI assigned
Apr 2, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

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
Vascular Surgery Physician 2086S0129X D98294 MD Primary

Addresses

Primary practice location

1411 E 31St St
Qic 22134
Oakland, CA 94602-1018

Mailing address

3910 Georgia Ave NW
322
Washington, DC 20011-5883
Phone (925) 548-6023

Other names 1

  • Jessica Brown Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC, VA3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20231006002396 MD Practitioner - Vascular SurgeryPractitioner - General Surgery 1850670662 Reassigns benefits to 3 organizations
I20231006002727 DC Practitioner - Vascular SurgeryPractitioner - General Surgery 1850670662 Reassigns benefits to 5 organizations
I20231106000437 VA Practitioner - Vascular SurgeryPractitioner - General Surgery 1850670662 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: General Surgery
Education
Howard University College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kaiser Foundation Health Plan of the Mid Atlantic States, IncGroup PAC ID 3779495858, shared by 17 NPIs, 1,921 clinicians

Practice addresses (Care Compare)

1221 Mercantile LN
Largo, MD 20774-5374
Phone (301) 618-5700

13285 Minnieville Rd
Woodbridge, VA 22192-4018
Phone (703) 986-2400

2391 Greenspring Dr
Timonium, MD 21093-6038
Phone (301) 816-2424

8008 Westpark Dr
MC Lean, VA 22102-3109
Phone (703) 287-6400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
141540CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Sep 18, 2023 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Sep 18, 2023 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Sep 18, 2023 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Sep 18, 2023 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Sep 18, 2023 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Sep 18, 2023 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Sep 18, 2023 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Sep 18, 2023 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Sep 18, 2023 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Sep 18, 2023 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Sep 18, 2023 Accepting new patients

Locations

7070 Samuel Morse Dr
Columbia, MD 21046
Phone (410) 309-4600

7190 Crestwood Blvd
Frederick, MD 21703
Phone (240) 529-1700

1701 Twin Springs Rd
Halethorpe, MD 21227
Phone (410) 737-5000

10810 Connecticut Ave
Kensington, MD 20895
Phone (301) 929-7100

1221 Mercantile Ln
Fl 3
Largo, MD 20774
Phone (301) 618-5500

655 Watkins Mill Rd
Montgomery Village, MD 20879
Phone (301) 929-7100

2101 E Jefferson St
Ste 4EPFS
Rockville, MD 20852

2101 E Jefferson St
Ste 4EAST
Rockville, MD 20852

2101 E Jefferson St
#4E
Rockville, MD 20852

2101 E Jefferson St
Ste 6WPPQA
Rockville, MD 20852
Phone (301) 816-5853

2391 Greenspring Dr
Timonium, MD 21093
Phone (410) 847-3000

6701 N Charles St
Towson, MD 21204
Phone (443) 849-2000

1221 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 618-5500

8008 Westpark Dr
Tysons Corner, VA 22102
Phone (703) 287-6400

14139 Potomac Mills Rd
Woodbridge, VA 22192
Phone (703) 257-3000

13285 Minnieville Rd
Woodbridge, VA 22192
Phone (703) 986-2400

Organizations & group practices 11

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1396396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1497173975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3910 GEORGIA AVE NW",
            "address_2": "322",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200115883",
            "telephone_number": "925-548-6023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 E 31ST ST",
            "address_2": "QIC 22134",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946021018",
            "telephone_number": "510-437-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REA",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-02",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MD",
            "license": "D98294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1411 E 31st St",
            "address_2": "QIC 22134",
            "city": "Oakland",
            "state": "CA",
            "country_code": "US",
            "postal_code": "946021018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "BROWN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.