Individual provider Active NPI

Mahima Jain, P.A.

  • Physician Assistant
  • Pleasant Hill, CA
National Provider Identifier
1730165093
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
51519 Issued in CA
Practice address
2250 Morello Ave
Pleasant Hill, CA 94523-1860
Phone
(925) 287-1256
Fax
(925) 287-0913
NPI assigned
Dec 19, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 51519 CA Primary

Addresses

Primary practice location

2250 Morello Ave
Pleasant Hill, CA 94523-1860

Mailing address

2250 Morello Ave
Pleasant Hill, CA 94523-1860
Phone (925) 287-1256

Other identifiers 1

IdentifierTypeStateIssuer
51519OtherCAMEDICAL LICENSE

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160810000919 CA Practitioner - Physician Assistant 3476535717 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
51519CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Bass Medical Group CurrentSince Sep 1, 2016 Accepting new patients
Bass Medical Group CurrentSince Sep 1, 2016 Accepting new patients
Bass Medical Group Past Accepting new patients

Locations

1505 Saint Alphonsus Way
Alamo, CA 94507
Phone (925) 837-4225

2250 Morello Ave
Pleasant Hill, CA 94523
Phone 9252871256121

2637 Shadelands Dr
Walnut Creek, CA 94598
Phone (925) 627-3424

Interoperability endpoints

  • Direct secure messaging: mjain71339@ehr.johnmuirhealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1730165093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 MORELLO AVE",
            "city": "PLEASANT HILL",
            "state": "CA",
            "postal_code": "945231860",
            "telephone_number": "925-287-1256",
            "fax_number": "925-287-0913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 MORELLO AVE",
            "city": "PLEASANT HILL",
            "state": "CA",
            "postal_code": "945231860",
            "telephone_number": "925-287-1256",
            "fax_number": "925-287-0913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAIN",
        "first_name": "MAHIMA",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-19",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "51519",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "51519",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasant Hill, CA

Sources for this page

Verify at the official NPI Registry.