Michael Jin

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

A129172 Issued in CA

Practice address

3801 Miranda Ave
Palo Alto, CA 94304-1207

Phone

(650) 493-5000

NPI assigned

May 19, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Specialty

Diagnostic Radiology

Education

University of California, San Diego School of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

X-Ray Medical Group IncGroup PAC ID 5294796801, 44 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Grossmont Hospital Hospital, La Mesa, CA, CCN 050026
• Kaiser Foundation Hospital - Sacramento Hospital, Sacramento, CA, CCN 050425
• Kaiser Foundation Hospital - Redwood City Hospital, Redwood City, CA, CCN 050541
• Kaiser Foundation Hosp So Sacramento Hospital, Sacramento, CA, CCN 050674
• Kaiser Foundation Hospital - Vacaville Hospital, Vacaville, CA, CCN 050767

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299

  Diagnostic Radiology

  Medicare reassignment Care Compare group NPD
• X-Ray Medical Group Inc

  • Diagnostic Radiology Physician
  • La Mesa, CA
  • NPI 1740232776
  Medicare reassignment Care Compare group NPD
• Regents of the Univ of Ca

  • Maternal & Fetal Medicine Physician
  • Sacramento, CA
  • NPI 1013906973
  Medicare reassignment NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Redwood City, CA
  • NPI 1639252604

  Diagnostic Radiology

  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD
• Regents of the Univ of Ca

  • Diagnostic Radiology Physician
  • Sacramento, CA
  • NPI 1477546406
  NPD
• Regents of the Univ of Ca

  • Surgical Oncology Physician
  • Sacramento, CA
  • NPI 1801889068
  NPD

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

• Grossmont Hospital Corporation

  • General Acute Care Hospital
  • La Mesa, CA
  • NPI 1528041811
  Care Compare affiliation
• Kaiser Foundation Hospitals

  • General Acute Care Hospital
  • Redwood City, CA
  • NPI 1386714814
  Care Compare affiliation
• Kaiser Foundation Hospitals

  • General Acute Care Hospital
  • Sacramento, CA
  • NPI 1528138088
  Care Compare affiliation
• Kaiser Foundation Hospitals

  • General Acute Care Hospital
  • Vacaville, CA
  • NPI 1710116116
  Care Compare affiliation
• Kaiser Foundation Hospitals

  • General Acute Care Hospital
  • Sacramento, CA
  • NPI 1952476665
  Care Compare affiliation

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

{
    "created_epoch": "1368921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1669818597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3134 GREER RD",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943034026",
            "telephone_number": "650-799-8127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 MIRANDA AVE",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041207",
            "telephone_number": "650-493-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIN",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-19",
        "last_updated": "2021-12-17",
        "certification_date": "2021-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A129172",
            "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": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1 Quality Dr",
            "city": "Vacaville",
            "state": "CA",
            "country_code": "US",
            "postal_code": "956889494",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christina E. Jimenez, MSW
• Kayla Jimenez, PSYD
• Nyzeth Jimenez
• Samay Singh Jimenez
• Maria Jin
• Asmita Arvind Jina, D.O.
• Arineh Joakim
• Joan L Mendelson, PH.D.
• Joann Blessing - Moore MD Inc
• Joann Lemaistre, PH.D. a Psychological Corporation

• Diagnostic Radiology Physician in Palo Alto, CA
• Providers in Palo Alto, CA by specialty
• Diagnostic Radiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; 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.