NPIMap

Individual provider Active NPI

Jeffrey G Blue, M.D.

  • Sports Medicine (Family Medicine) Physician
  • Campbell, CA
National Provider Identifier
1801900220
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
A060369 Issued in CA
Practice address
221 E Hacienda Ave Ste C
Campbell, CA 95008-6625
Phone
(408) 404-4700
Fax
(408) 404-4701
NPI assigned
Aug 19, 2006
Last updated
Nov 12, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X A060369 CA Primary

Addresses

Primary practice location

221 E Hacienda Ave Ste C
Campbell, CA 95008-6625

Mailing address

221 E Hacienda Ave Ste C
Campbell, CA 95008-6625
Phone (408) 404-4700

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
I20040507000711 CA Practitioner - Family PracticePractitioner - Sports MedicinePractitioner - Physical Medicine and Rehabilitation 7517954084 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Sports Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bass Medical GroupGroup PAC ID 9032111281, 292 clinicians

Practice addresses (Care Compare)

15899 Los Gatos Almaden Rd
Suite 12
Los Gatos, CA 95032-3739
Phone (408) 358-2663

221 E Hacienda Ave
Campbell, CA 95008-6625

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A060369CAMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orthonorcal, Inc. CurrentSince May 1, 2021 Accepting new patients
Bass Medical Group CurrentSince Jan 1, 2024 Accepting new patients
Golden State Orthopedics & Spine CurrentSince Jan 1, 2022 Accepting new patients
Bass Medical Group CurrentSince Jan 1, 2024 Accepting new patients
Orthonorcal Inc CurrentSince May 1, 2021 Accepting new patients
Golden State Orthopedics & Spine CurrentSince Jan 1, 2022 Accepting new patients
County of Santa Clara Past Accepting new patients
El Camino Hospital Past Accepting new patients
Bass Medical Group Past Accepting new patients
UCSF Health Community Hospitals Past Accepting new patients
Good Samaritan Hospital, L.P. Past Accepting new patients
Bass Medical Group Past Accepting new patients
Golden State Orthopedics & Spine Past Accepting new patients
Seton Medical Center Past Accepting new patients
California Sports Physical Therapy Centers Inc Past Accepting new patients

Locations

221 E Hacienda Ave
Ste C
Campbell, CA 95008
Phone (408) 374-5700

15899 Los Gatos Almaden Rd
Ste 12
Los Gatos, CA 95032
Phone (408) 358-2663

340 Dardanelli Ln
Ste 10
Los Gatos, CA 95032
Phone (408) 412-8100

455 Oconnor Dr
Ste 150
San Jose, CA 95128
Phone (408) 947-2522

900 Lafayette St
Ste 105
Santa Clara, CA 95050
Phone (408) 556-8407

2405 Shadelands Dr
Walnut Creek, CA 94598
Phone (615) 930-0820

365 Lennon Ln
Ste 250
Walnut Creek, CA 94598
Phone (925) 627-3424

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: jeffery.blue.1@25176.direct.athenahealth.com
  • Direct secure messaging: jeffrey.blue.p2@direct.muirortho.nextgenshare.com
  • Direct secure messaging: jeffrey.bluemd.p1@direct.orthonorcal.nextgenshare.com

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 9

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": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1801900220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 E HACIENDA AVE STE C",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950086625",
            "telephone_number": "408-404-4700",
            "fax_number": "408-404-4701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 E HACIENDA AVE STE C",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950086625",
            "telephone_number": "408-404-4700",
            "fax_number": "408-404-4701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUE",
        "first_name": "JEFFREY",
        "middle_name": "G",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "CA",
            "license": "A060369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Campbell, CA

Sources for this page

Verify at the official NPI Registry.