NPIMap

Individual provider Active NPI

Javid J Javidan-Nejad, MD

  • Urology Physician
  • Carmichael, CA
National Provider Identifier
1679558605
Registry record updated Dec 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
A83658 Issued in CA
Practice address
6620 Coyle Avenue
Suite 301
Carmichael, CA 95608-6337
Phone
(916) 961-2514
Fax
(916) 961-1182
NPI assigned
Dec 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X A83658 CA Primary

Addresses

Primary practice location

6620 Coyle Avenue
Suite 301
Carmichael, CA 95608-6337

Mailing address

3400 Data Drive
Credentialing Department
Rancho Gordova, CA 95670-7956
Phone (916) 734-5154

Other identifiers 1

IdentifierTypeStateIssuer
00A836580MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060302000215 CA Practitioner - Urology 0547276461 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Javidan Urology IncGroup PAC ID 5496028201, 5 clinicians

Practice addresses (Care Compare)

6600 Coyle Ave
Suite 1
Carmichael, CA 95608-6344
Phone (916) 245-2444

Hospital & facility affiliations

  • Mercy San Juan Medical Center Hospital, Carmichael, CA, CCN 050516
  • Sutter Roseville Medical Center Hospital, Roseville, CA, CCN 050309
  • Mercy General Hospital Hospital, Sacramento, CA, CCN 050017
  • Marshall Medical Center Hospital, Placerville, CA, CCN 050254

Merit-based Incentive Payment System (MIPS)

Final score
25.09 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
83.65

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
83658CAMDMental Health Counselor
A83658CAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Javidan Urology, Inc Urology CurrentSince Jun 24, 2017 Accepting new patients
Dignity Health Past Accepting new patients
Dignity Health Past Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
Regents of the Univ of Ca Past Accepting new patients
Dignity Health Past Accepting new patients
Sutter North Medical Foundation Past Accepting new patients

Locations

6600 Coyle Ave
Ste 1
Carmichael, CA 95608
Phone (916) 245-2444

2360 E Bidwell St
Ste 100
Folsom, CA 95630
Phone (916) 936-1010

729 Sunrise Ave
Ste 200
Roseville, CA 95661
Phone (916) 245-2444

Organizations & group practices 7

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 4

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": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387497600000",
    "number": "1679558605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DRIVE",
            "address_2": "CREDENTIALING DEPARTMENT",
            "city": "RANCHO GORDOVA",
            "state": "CA",
            "postal_code": "956707956",
            "telephone_number": "916-734-5154",
            "fax_number": "916-734-8094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6620 COYLE AVENUE",
            "address_2": "SUITE 301",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956086337",
            "telephone_number": "916-961-2514",
            "fax_number": "916-961-1182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAVIDAN-NEJAD",
        "first_name": "JAVID",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-13",
        "last_updated": "2013-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "A83658",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A836580",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmichael, CA

Sources for this page

Verify at the official NPI Registry.