NPIMap

Individual provider Active NPI

Jason Gotlib, M.D., M.S.

  • Hematology (Internal Medicine) Physician
  • Palo Alto, CA
National Provider Identifier
1790827640
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology (Internal Medicine) PhysicianTaxonomy code 207RH0000X
License
A060833 Issued in CA
Practice address
875 Blake Wilbur Dr RM 2327B
Palo Alto, CA 94304-2205
Phone
(650) 736-1253
Fax
(650) 724-5203
NPI assigned
Feb 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology (Internal Medicine) Physician 207RH0000X A060833 CA Primary

Addresses

Primary practice location

875 Blake Wilbur Dr RM 2327B
Palo Alto, CA 94304-2205

Mailing address

875 Blake Wilbur Drive, Room 2327B
Stanford, CA 94305-5821
Phone (650) 736-1253

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
I20081210000495 CA Practitioner - HematologyPractitioner - Internal MedicinePractitioner - Hematology/Oncology 0446311302 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HematologyAlso: Hematology/Oncology, Internal Medicine
Education
Stanford University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Stanford Health CareGroup PAC ID 6709797491, 3,152 clinicians

Practice addresses (Care Compare)

300 Pasteur Dr
Stanford, CA 94305-2200
Phone (650) 723-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.53 of 100Reported as group
Quality
87.08
Promoting interoperability
100
Improvement activities
40
Cost
69.51

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A060833CAMDHematology (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stanford Health Care CurrentSince Jan 14, 2004 Accepting new patients
Stanford Health Care Current Accepting new patients
Stanford Health Care CurrentSince Jan 14, 2004 Accepting new patients
Lucile Salter Packard Children'S Hospital at Stanford Past Accepting new patients
Stanford Hospital and Clinics Past Accepting new patients

Locations

875 Blake Wilbur Dr
Palo Alto, CA 94304
Phone (650) 723-7621

875 Blake Wilbur Dr
Rm 2327B
Palo Alto, CA 94304
Phone (650) 736-1253

300 Pasteur Dr
#5500
Stanford, CA 94305
Phone (415) 723-5525

300 Pasteur Dr
Stanford, CA 94305
Phone (650) 498-5710

Interoperability endpoints

  • Direct secure messaging: jgotlib3118@direct.stanfordhealthcare.org

Organizations & group practices 5

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 10

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": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790827640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 BLAKE WILBUR DRIVE, ROOM 2327B",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943055821",
            "telephone_number": "650-736-1253",
            "fax_number": "650-724-5203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 BLAKE WILBUR DR RM 2327B",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943042205",
            "telephone_number": "650-736-1253",
            "fax_number": "650-724-5203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTLIB",
        "first_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "M.D., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "CA",
            "license": "A060833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

Verify at the official NPI Registry.