NPIMap

Individual provider Active NPI

Carson Welty, M.D.

  • Pediatrics Physician
  • San Jose, CA
National Provider Identifier
1518234889
Registry record updated Jul 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A118872 Issued in CA
Practice address
750 S Bascom Ave
San Jose, CA 95128-2603
Phone
(888) 334-1000
Fax
(408) 885-6718
NPI assigned
Nov 30, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A118872 CA Primary

Addresses

Primary practice location

750 S Bascom Ave
San Jose, CA 95128-2603

Mailing address

750 S Bascom Ave
San Jose, CA 95128-2603
Phone (888) 334-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2010
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Pasadena, CA 91189

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A118872CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital & Research Center at Oakland Past Accepting new patients
County of Santa Clara Past Accepting new patients
County of Santa Clara Pediatrics Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: cwelty49930@santaclaravalley.direct-ci.net

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": "1322611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405555200000",
    "number": "1518234889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 S BASCOM AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282603",
            "telephone_number": "888-334-1000",
            "fax_number": "408-885-6718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 S BASCOM AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282603",
            "telephone_number": "888-334-1000",
            "fax_number": "408-885-6718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELTY",
        "first_name": "CARSON",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-30",
        "last_updated": "2014-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A118872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.