Organization Active NPI

Anthony J Badame MD a Professional Corporation

  • Dermatology Physician
  • San Jose, CA
National Provider Identifier
1699509059
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
ANTHONY J BADAME MD A PROFESSIONAL CORPORATION
Practice address
2025 Forest Ave Ste 9
San Jose, CA 95128-4806
Phone
(408) 297-4200
Fax
(408) 297-2503
NPI assigned
Aug 28, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Authorized official

Name
Melissa Badame
Title
Office Manager
Phone
(408) 828-0284

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

2025 Forest Ave Ste 9
San Jose, CA 95128-4806

Mailing address

2025 Forest Ave Ste 9
San Jose, CA 95128-4806
Phone (408) 297-4200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241206002470 CA Part B Supplier - Clinic/Group Practice 1355877846 Receives reassigned benefits from 1 practitioner
Practice locations: San Jose, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0608454Anthony J Badame MD2025 Forest Ave, Ste 9, San Jose, CA 95128ComplianceApr 14, 2027

National Provider Directory

National Provider Directory

Locations

2025 Forest Ave
Ste 9
San Jose, CA 95128
Phone (408) 297-4200

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1724803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729036800000",
    "number": "1699509059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 FOREST AVE STE 9",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951284806",
            "telephone_number": "408-297-4200",
            "fax_number": "408-297-2503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 FOREST AVE STE 9",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951284806",
            "telephone_number": "408-297-4200",
            "fax_number": "408-297-2503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTHONY J BADAME MD A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-28",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A",
        "authorized_official_last_name": "BADAME",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "408-828-0284"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.