Individual provider Active NPI

Jeffrey Crowder, MD

  • Emergency Medicine Physician
  • South San Francisco, CA
National Provider Identifier
1710065313
Registry record updated Sep 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A88401 Issued in CA
Practice address
1200 El Camino Real
South San Francisco, CA 94080-3208
Phone
(650) 742-2000
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A88401 CA Primary

Addresses

Primary practice location

1200 El Camino Real
South San Francisco, CA 94080-3208

Mailing address

1800 Harrison St FL 7
Oakland, CA 94612-3429
Phone (510) 625-6262

Other identifiers 1

IdentifierTypeStateIssuer
00A884010MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20241121003692 TX Practitioner - Emergency Medicine 4981657053 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Medical College of Pennsylvania, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Winslow Indian Health Care Center IncGroup PAC ID 4284548991, 99 clinicians

Practice addresses (Care Compare)

1 5 Miles N of Leupp Chapter House
Leupp Health Station
Leupp, AZ 86035
Phone (928) 289-4646

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A88401CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Winslow Indian Health Care Center, Inc Current Accepting new patients
Dilkon Medical Center Current Accepting new patients
Winslow Indian Health Care Center, Inc CurrentSince Oct 24, 2024 Accepting new patients
Winslow Indian Health Care Center, Inc CurrentSince Oct 24, 2024 Accepting new patients
Emcare Physician Providers, Inc Emergency Medicine Past Accepting new patients
Emergency Health Partners-Verde Valley PLC Emergency Medicine Past Accepting new patients
Willard Emergency Physicians Emergency Medicine Past Accepting new patients
John Muir Physician Network Past Accepting new patients

Locations

500 Indiana Ave
Winslow, AZ 86047

1501 N Williamson Ave
Winslow, AZ 86047
Phone (928) 289-4691

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190073600000",
    "number": "1710065313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 HARRISON ST FL 7",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946123429",
            "telephone_number": "510-625-6262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 EL CAMINO REAL",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940803208",
            "telephone_number": "650-742-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROWDER",
        "first_name": "JEFFREY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A88401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A884010",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South San Francisco, CA

Sources for this page

Verify at the official NPI Registry.