Jimmie Mar, D.O.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

20A20119 Issued in CA

Practice address

1721 Technology Dr
San Jose, CA 95110-1305

Phone

(408) 436-3300

NPI assigned

Apr 28, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA, WA2 enrollments

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 2

Specialty

Internal Medicine

Education

Touro Un Col of Osteopathic Medicine, Henderson, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

King County Public Hospital District No 2Group PAC ID 7618880097, 586 clinicians

Select Outpatient Services IncGroup PAC ID 4082868815, 750 clinicians

Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Evergreenhealth Home Care Services Home health agency, Kirkland, WA, CCN 507079
• Evergreenhealth Medical Center Hospital, Kirkland, WA, CCN 500124
• Evergreenhealth Monroe Hospital, Monroe, WA, CCN 500084

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• King County Public Hospital District No 2

  • Neuromusculoskeletal Medicine & OMM Physician
  • Kirkland, WA
  • NPI 1801986070
  Medicare reassignment Care Compare group NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299
  Medicare reassignment NPD
• Select Rehabilitation, LLC

  • Rehabilitation Clinic/Center
  • Glenview, IL
  • NPI 1346368248
  Care Compare group
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Stockton, CA
  • NPI 1548343510
  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD
• King County Public Hospital District No 2

  • Family Medicine Physician
  • Bothell, WA
  • NPI 1902907165
  NPD
• King County Public Hospital District No. 2

  • Physical Therapist
  • Kirkland, WA
  • NPI 1356920946
  NPD
• King County Public Hospital District No. 2

  • Clinic/Center
  • Redmond, WA
  • NPI 1750612883
  NPD
• King County Public Hospital District No 2

  • Obstetrics Physician
  • Kirkland, WA
  • NPI 1891883435
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• King County Public Hospital District No. 2

  • General Acute Care Hospital
  • Kirkland, WA
  • NPI 1033174933
  Care Compare affiliation
• King County Public Hospital District No. 2

  • Home Health Agency
  • Kirkland, WA
  • NPI 1588662761
  Care Compare affiliation
• Public Hospital District 1 of Snohomish County

  • General Acute Care Hospital
  • Monroe, WA
  • NPI 1013074061
  Care Compare affiliation
• Public Hospital District No 1 of Snohomish County

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Monroe, WA
  • NPI 1770614273
  Care Compare affiliation

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

{
    "created_epoch": "1493337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662336000000",
    "number": "1649705567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1721 TECHNOLOGY DR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951101305",
            "telephone_number": "408-436-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 TECHNOLOGY DR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951101305",
            "telephone_number": "408-436-3300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Ivy St",
            "address_purpose": "LOCATION",
            "city": "Elmira",
            "state": "NY",
            "postal_code": "149051627",
            "country_code": "US",
            "telephone_number": "775-830-7009",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "830 Washington St",
            "address_purpose": "LOCATION",
            "city": "Watertown",
            "state": "NY",
            "postal_code": "136014099",
            "country_code": "US",
            "telephone_number": "315-785-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAR",
        "first_name": "JIMMIE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-28",
        "last_updated": "2022-09-05",
        "certification_date": "2022-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "305596",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A20119",
            "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": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1721 Technology Dr",
            "city": "San Jose",
            "state": "CA",
            "country_code": "US",
            "postal_code": "951101305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Samphors Thong Mao, LCSW
• Wenming Mao, L.AC
• Angela Mapanao
• Glenna Maple, L.AC., R.N.
• Katie M Maples
• John C. Mar, MD
• Kathryn L. Mar, MD
• Marilyn Mara, R.N.
• Cindy Maradiga
• Allysa Maralit

• Internal Medicine Physician in San Jose, CA
• Providers in San Jose, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.