Individual provider Active NPI

Kedy Ying Jao, D.O.

  • Family Medicine Physician
  • Brea, CA
National Provider Identifier
1629144464
Registry record updated Jul 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A4947 Issued in CA
Practice address
500 S Kraemer Blvd
#240
Brea, CA 92821-6728
Phone
(714) 930-1351
Fax
(714) 930-1361
NPI assigned
Nov 24, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A4947 CA Primary

Addresses

Primary practice location

500 S Kraemer Blvd
#240
Brea, CA 92821-6728

Mailing address

500 S Kraemer Blvd
#240
Brea, CA 92821-6728
Phone (714) 930-1351

Other names 1

  • Dr. Kedy Ying Jao Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
28.63 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
95.43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4947CAMDPediatric Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689206400000",
    "number": "1629144464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S KRAEMER BLVD",
            "address_2": "#240",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928216728",
            "telephone_number": "714-930-1351",
            "fax_number": "714-930-1361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S KRAEMER BLVD",
            "address_2": "#240",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928216728",
            "telephone_number": "714-930-1351",
            "fax_number": "714-930-1361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAO",
        "first_name": "KEDY",
        "middle_name": "YING",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-24",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A4947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KEDY",
            "last_name": "JAO",
            "middle_name": "YING",
            "prefix": "DR.",
            "credential": "D.O.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Brea, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.