Individual provider Active NPI

Jacque R. Jumper, MD

  • Diagnostic Radiology Physician
  • Oakland, CA
National Provider Identifier
1538231345
Registry record updated Jan 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A77470 Issued in CA
Practice address
275 W Macarthur Blvd
Oakland, CA 94611-5641
Phone
(510) 752-1000
NPI assigned
Nov 15, 2006
Last updated
Jan 10, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X A77470 CA Primary

Addresses

Primary practice location

275 W Macarthur Blvd
Oakland, CA 94611-5641

Mailing address

275 W Macarthur Blvd
Oakland, CA 94611-5641
Phone (510) 752-1000

Other identifiers 1

IdentifierTypeStateIssuer
00A774700MedicaidCA

Other names 1

  • Jacque Renae Wettlaufer Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040607001543 CA Practitioner - Diagnostic Radiology 8820071327 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Minnesota Medical School, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

1425 S Main St
Walnut Creek, CA 94596-5318
Phone (925) 295-4000

1600 Eureka Rd
Roseville, CA 95661-3027
Phone (916) 784-4000

1643 Eureka Rd
Roseville, CA 95661-3027
Phone (916) 973-5300

2025 Morse Ave
Sacramento, CA 95825-2115
Phone (916) 973-5000

250 Hospital Pkwy
San Jose, CA 95119-1103
Phone (408) 972-3000

275 W Macarthur Blvd
Oakland, CA 94611-5641
Phone (510) 752-1000

280 Hospital Pkwy
San Jose, CA 95119-1103
Phone (408) 972-3000

401 Bicentennial Way
Santa Rosa, CA 95403-2149
Phone (707) 393-4000

6600 Bruceville Rd
Sacramento, CA 95823-4671
Phone (916) 688-2000

700 Lawrence Expy
Santa Clara, CA 95051-5173
Phone (408) 851-1000

710 Lawrence Express Way
Santa Clara, CA 95051-5173
Phone (408) 851-1000

901 Nevin Ave
Richmond, CA 94801-3143
Phone (510) 307-1500

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc Diagnostic Radiology Current Accepting new patients
Permanente Medical Group, Inc CurrentSince Nov 1, 2010 Accepting new patients
Permanente Medical Group Inc Diagnostic Radiology CurrentSince Nov 1, 2010 Accepting new patients

Locations

1800 Harrison St
Fl 7
Oakland, CA 94612

280 W MacArthur Blvd
Oakland, CA 94611
Phone (510) 596-1000

275 W MacArthur Blvd
Piedmont, CA 94611
Phone (510) 752-1375

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641772800000",
    "number": "1538231345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 W MACARTHUR BLVD",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946115641",
            "telephone_number": "510-752-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 W MACARTHUR BLVD",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946115641",
            "telephone_number": "510-752-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUMPER",
        "first_name": "JACQUE",
        "middle_name": "R.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2022-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A77470",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A774700",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "275 W MacArthur Blvd",
            "city": "Oakland",
            "state": "CA",
            "country_code": "US",
            "postal_code": "946115641",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JACQUE",
            "last_name": "WETTLAUFER",
            "middle_name": "RENAE",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.