Individual provider Active NPI

Jaimish Gwalani

  • Interventional Pain Medicine Physician
  • Fremont, CA
National Provider Identifier
1689036824
Registry record updated Mar 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
A151701 Issued in CA
Practice address
38437 Mission Blvd Ste 101
Fremont, CA 94536-4318
Phone
(510) 806-1425
Fax
(510) 768-8758
NPI assigned
Mar 27, 2016
Last updated
Mar 23, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X A151701 CA Primary

Addresses

Primary practice location

38437 Mission Blvd Ste 101
Fremont, CA 94536-4318

Mailing address

38437 Mission Blvd Ste 101
Fremont, CA 94536-4318
Phone (510) 806-1425

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
I20200930002695 CA Practitioner - Pain ManagementPractitioner - Internal Medicine 4587925714 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Internal Medicine
Education
Other, 2016
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Fremont Pain Treamtment CenterGroup PAC ID 9638321755, 4 clinicians

Practice addresses (Care Compare)

656 Mowry Ave
Fremont, CA 94536-4113
Phone (510) 818-9237

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fremont Pain Treamtment Center CurrentSince Sep 1, 2020 Accepting new patients
Empire Anesthesia Inc Interventional Pain Medicine CurrentSince Sep 1, 2020 Accepting new patients
County of Santa Clara Interventional Pain Medicine Past Accepting new patients

Locations

656 Mowry Ave
Fremont, CA 94536
Phone (510) 742-5511

125 N Jackson Ave
Ste 106
San Jose, CA 95116
Phone (408) 837-7252

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1459036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1689036824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38437 MISSION BLVD STE 101",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945364318",
            "telephone_number": "510-806-1425",
            "fax_number": "510-768-8758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38437 MISSION BLVD STE 101",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945364318",
            "telephone_number": "510-806-1425",
            "fax_number": "510-768-8758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GWALANI",
        "first_name": "JAIMISH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-27",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "CA",
            "license": "A151701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

Verify at the official NPI Registry.