Individual provider Active NPI

Elie Jean, MD

  • Pulmonary Disease Physician
  • Roseville, CA
National Provider Identifier
1558712182
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
A168259 Issued in CA
Practice address
5 Medical Plaza Dr Ste 190
Roseville, CA 95661-2867
Phone
(916) 679-3590
Fax
(916) 786-7498
NPI assigned
Jun 24, 2016
Last updated
Jul 17, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X A168259 CA Primary

Addresses

Primary practice location

5 Medical Plaza Dr Ste 190
Roseville, CA 95661-2867

Mailing address

1300 Ethan Way Ste 600
Sacramento, CA 95825-2296
Phone (916) 482-7623

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
I20230818003197 CA Practitioner - Pulmonary Disease 0345602587 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pulmonary Medicine Associates Medical Group Inc.Group PAC ID 4981506730, 93 clinicians

Practice addresses (Care Compare)

5 Medical Plaza Dr
Suite 190
Roseville, CA 95661-2867
Phone (916) 679-3590

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.24 of 100Reported as individual
Quality
83.28
Promoting interoperability
100
Improvement activities
40
Cost
67.52

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A168259CAMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pulmonary Medicine Associates Sleep Lab Inc. Pulmonary Disease CurrentSince Aug 1, 2023 Accepting new patients
Pulmonary Medicine Associates Medical Group, Inc Pulmonary Disease CurrentSince Aug 1, 2023 Accepting new patients

Locations

6403 Coyle Ave
Ste 450
Carmichael, CA 95608
Phone (916) 482-7621

5 Medical Plaza Dr
Ste 190
Roseville, CA 95661
Phone (916) 679-3590

1300 Ethan Way
Ste 600
Sacramento, CA 95825
Phone (916) 482-7623

1485 River Park Dr
Ste 200
Sacramento, CA 95815
Phone (916) 325-1040

Interoperability endpoints

  • Direct secure messaging: elie.jean.1@1119.direct.athenahealth.com

Organizations & group practices 2

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 6

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": "1466726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1558712182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 ETHAN WAY STE 600",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958252296",
            "telephone_number": "916-482-7623",
            "fax_number": "916-482-3647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 MEDICAL PLAZA DR STE 190",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612867",
            "telephone_number": "916-679-3590",
            "fax_number": "916-786-7498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEAN",
        "first_name": "ELIE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-24",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "A168259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.