Individual provider Active NPI

San San Myint, MD

  • Internal Medicine Physician
  • San Jose, CA
National Provider Identifier
1609944933
Registry record updated Jul 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A051537 Issued in CA
Practice address
150 N Jackson Ave
# 100
San Jose, CA 95116-1908
Phone
(408) 621-1536
Fax
(408) 973-8923
NPI assigned
Dec 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A051537 CA Primary

Addresses

Primary practice location

150 N Jackson Ave
# 100
San Jose, CA 95116-1908

Mailing address

5676 Kimberly St
San Jose, CA 95129-3135
Phone (408) 621-1536

Other identifiers 1

IdentifierTypeStateIssuer
A 51537OtherCACALIFORNIA LICENCE

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
I20091019000010 CA Practitioner - Internal Medicine 4981741345 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3755 Beacon Ave
Fremont, CA 94538-1411
Phone (510) 992-6783

Hospital & facility affiliations

  • Washington Hospital Hospital, Fremont, CA, CCN 050195
  • Ahmc Seton Medical Center Hospital, Daly City, CA, CCN 050289

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mintz Medical Corporation Internal Medicine CurrentSince Jun 23, 2009 Accepting new patients
County of Santa Clara Past Accepting new patients

Locations

3755 Beacon Ave
Fremont, CA 94538
Phone (510) 760-4512

105 N Jackson Ave
Ste 103
San Jose, CA 95116
Phone (408) 251-9191

150 N Jackson Ave
Ste 100
San Jose, CA 95116
Phone (408) 769-5340

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216339200000",
    "number": "1609944933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5676 KIMBERLY ST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951293135",
            "telephone_number": "408-621-1536",
            "fax_number": "408-973-8923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 N JACKSON AVE",
            "address_2": "# 100",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951161908",
            "telephone_number": "408-621-1536",
            "fax_number": "408-973-8923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYINT",
        "first_name": "SAN SAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2008-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A051537",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA LICENCE",
            "identifier": "A 51537",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.