Individual provider Active NPI

Jane Show Wada, MD

  • Dermatology Physician
  • Montrose, CA
National Provider Identifier
1609862242
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
G30116 Issued in CA
Practice address
2103 Montrose Ave
Suite D
Montrose, CA 91020-1546
Phone
(818) 957-2066
Fax
(818) 957-0689
NPI assigned
Sep 20, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X G30116 CA Primary

Addresses

Primary practice location

2103 Montrose Ave
Suite D
Montrose, CA 91020-1546

Mailing address

2103 Montrose Ave
Suite D
Montrose, CA 91020-1546
Phone (818) 957-2066

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
I20090814000106 CA Practitioner - Dermatology 6709930480 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Su and Chang Dermatology Associates ApmcGroup PAC ID 2062641103, 3 clinicians

Practice addresses (Care Compare)

1809 Verdugo Blvd
Glendale, CA 91208-1402
Phone (818) 658-2300

3600 N Verdugo Rd
Suite 210
Glendale, CA 91208-1258
Phone (818) 658-2300

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
99.39
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions706
Removal or shaving of skin growth1-10
Skin biopsy56

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G30116CAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Verdugo Hills Hospital, LLC Past Accepting new patients
Gabriel G. Pai, M.D. Inc. Dermatology Past Accepting new patients
Glendale Adventist Medical Center Past Accepting new patients
Dignity Health Past Accepting new patients

Organizations & group practices 5

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": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1609862242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2103 MONTROSE AVE",
            "address_2": "SUITE D",
            "city": "MONTROSE",
            "state": "CA",
            "postal_code": "910201546",
            "telephone_number": "818-957-2066",
            "fax_number": "818-957-0689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2103 MONTROSE AVE",
            "address_2": "SUITE D",
            "city": "MONTROSE",
            "state": "CA",
            "postal_code": "910201546",
            "telephone_number": "818-957-2066",
            "fax_number": "818-957-0689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADA",
        "first_name": "JANE",
        "middle_name": "SHOW",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-20",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "G30116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montrose, CA

Sources for this page

Verify at the official NPI Registry.