NPIMap

Individual provider Active NPI

Kenneth P Jiang, MD

  • Internal Medicine Physician
  • Hollister, CA
National Provider Identifier
1841279841
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A666280 Issued in CA
Practice address
901 Sunset Dr
#3
Hollister, CA 95023
Phone
(831) 636-4994
Fax
(831) 636-4996
NPI assigned
Jan 10, 2006
Sex
Male
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
Internal Medicine Physician 207R00000X A666280 CA Primary

Addresses

Primary practice location

901 Sunset Dr
#3
Hollister, CA 95023

Mailing address

591 McCray St Ste 231
Hollister, CA 95023-2224

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
I20090805000377 CA Practitioner - Internal MedicinePractitioner - General Practice 2466427091 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: General Practice
Education
University of Chicago, Pritzker School of Medicine, 1995
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)

591 McCray St
Suite 211
Hollister, CA 95023-2224
Phone (831) 636-3116

Hospital & facility affiliations

  • Dynamicare Home Health Home health agency, Fremont, CA, CCN 559444
  • Central Coast Vna & Hospice, Inc Home health agency, Monterey, CA, CCN 057002
  • Bonita Springs Home Health LLC Home health agency, Gilroy, CA, CCN 053142
  • Care Must Home health agency, San Jose, CA, CCN 059796
  • Premier Home Health Providers Inc. Home health agency, San Jose, CA, CCN 059180
  • Bonita Springs Hospice Care LLC Hospice, Gilroy, CA, CCN 751672
  • Hazel Hawkins Memorial Hospital Hospital, Hollister, CA, CCN 051337
  • Salinas Valley Health Medical Center Hospital, Salinas, CA, CCN 050334

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A666280CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Your Medical Group, Inc CurrentSince Sep 17, 2014 Accepting new patients
Bass Medical Group CurrentSince Dec 29, 2024 Accepting new patients
Bass Medical Group Current Accepting new patients
Bass Medical Group CurrentSince Dec 29, 2024 Accepting new patients
Felicidad G Lao-Domingo MD Inc Past Accepting new patients

Locations

243 Green Valley Rd
Ste B
Freedom, CA 95019
Phone (831) 724-9449

591 McCray St
Ste 231
Hollister, CA 95023
Phone (831) 636-3116

901 Sunset Dr
Ste 3
Hollister, CA 95023
Phone (831) 636-3116

591 McCray St
Ste 211
Hollister, CA 95023
Phone (831) 636-3116

384 Pearson Dr
Porterville, CA 93257
Phone (559) 781-5179

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

Interoperability endpoints

  • Direct secure messaging: kenneth.jiang.1@25176.direct.athenahealth.com

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 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": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1841279841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "591 MCCRAY ST STE 231",
            "city": "HOLLISTER",
            "state": "CA",
            "postal_code": "950232224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 SUNSET DR",
            "address_2": "#3",
            "city": "HOLLISTER",
            "state": "CA",
            "postal_code": "95023",
            "telephone_number": "831-636-4994",
            "fax_number": "831-636-4996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIANG",
        "first_name": "KENNETH",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A666280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollister, CA

Sources for this page

Verify at the official NPI Registry.