Individual provider Active NPI

Jai Chand Autar, M.D.

  • Pediatrics Physician
  • Crescent City, CA
National Provider Identifier
1548288491
Registry record updated Dec 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A99944 Issued in CA
Practice address
780 E Washington Blvd
Suite 202
Crescent City, CA 95531-8397
Phone
(707) 464-6715
NPI assigned
Jul 18, 2006
Last updated
Dec 13, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X TP642 KY
Pediatrics Physician 208000000X A99944 CA Primary

Addresses

Primary practice location

780 E Washington Blvd
Suite 202
Crescent City, CA 95531-8397

Mailing address

780 E Washington Blvd
Suite 202
Crescent City, CA 95531-8397
Phone (707) 464-6715

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
I20090912000157 CA Practitioner - Pediatric Medicine 3375648702 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A99944CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc Pediatrics Current Accepting new patients
Permanente Medical Group, Inc CurrentSince Oct 5, 2010 Accepting new patients
Community Medical Centers, Inc. Current Accepting new patients
Community Medical Centers, Inc CurrentSince Jul 7, 2025 Accepting new patients
Permanente Medical Group Inc Pediatrics CurrentSince Oct 5, 2010 Accepting new patients
Community Medical Centers Inc CurrentSince Jul 7, 2025 Accepting new patients
Physical Therapy Associates Inc Past Accepting new patients
A.M. Faheem, M.D., P.S.C. Specialist Past Accepting new patients

Locations

2401 W Turner Rd
Ste 450
Lodi, CA 95242
Phone (209) 370-1700

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

7210 Murray Dr
Stockton, CA 95210
Phone (209) 373-2816

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

730 N Central Ave
Tracy, CA 95376
Phone (209) 820-1500

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

Interoperability endpoints

  • Direct secure messaging: jautar816081@direct.ochin.org

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639353600000",
    "number": "1548288491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 E WASHINGTON BLVD",
            "address_2": "SUITE 202",
            "city": "CRESCENT CITY",
            "state": "CA",
            "postal_code": "955318397",
            "telephone_number": "707-464-6715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 E WASHINGTON BLVD",
            "address_2": "SUITE 202",
            "city": "CRESCENT CITY",
            "state": "CA",
            "postal_code": "955318397",
            "telephone_number": "707-464-6715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUTAR",
        "first_name": "JAI",
        "middle_name": "CHAND",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2021-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "KY",
            "license": "TP642",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A99944",
            "primary": true
        }
    ],
    "identifiers": [],
    "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": "7373 West Ln",
            "city": "Stockton",
            "state": "CA",
            "country_code": "US",
            "postal_code": "952103377",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Crescent City, CA

Sources for this page

Verify at the official NPI Registry.