Organization Active NPI

Alpha Telemedicine, PC

  • Family Medicine Physician
  • Palo Alto, CA
National Provider Identifier
1811637242
Registry record updated Jan 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ALPHA TELEMEDICINE, PC
Practice address
555 Bryant St Ste 814
Palo Alto, CA 94301-1704
Phone
(415) 663-5584
Fax
(844) 640-3975
NPI assigned
Apr 1, 2022
Last updated
Jan 17, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2023

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

Authorized official

Name
Dr. Mary Therese Jacobson, MD
Title
Chief Medical Officer
Phone
(415) 663-5584

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Primary Care Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP2300X

Addresses

Primary practice location

555 Bryant St Ste 814
Palo Alto, CA 94301-1704

Mailing address

555 Bryant St Ste 814
Palo Alto, CA 94301-1704

Other practice location 1

3327 Brighton Blvd
Denver, CO 80216-5020
Phone (415) 663-5584

National Provider Directory

National Provider Directory

Locations

555 Bryant St
Palo Alto, CA 94301
Phone (415) 663-5584

3327 Brighton Blvd
Denver, CO 80216
Phone (415) 663-5584

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1648771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673913600000",
    "number": "1811637242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 BRYANT ST STE 814",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943011704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 BRYANT ST STE 814",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943011704",
            "telephone_number": "415-663-5584",
            "fax_number": "844-640-3975"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3327 Brighton Blvd",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802165020",
            "country_code": "US",
            "telephone_number": "415-663-5584",
            "fax_number": "844-640-3975",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ALPHA TELEMEDICINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-01",
        "last_updated": "2023-01-17",
        "certification_date": "2022-04-09",
        "status": "A",
        "authorized_official_last_name": "JACOBSON",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "THERESE",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "415-663-5584",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.