NPIMap

Individual provider Active NPI

George Peter Kent, MD

  • Family Medicine Physician
  • San Jose, CA
National Provider Identifier
1861456246
Registry record updated Feb 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G46421 Issued in CA
Practice address
455 Oconnor Dr
Suite 210
San Jose, CA 95128-1633
Phone
(408) 995-5453
Fax
(408) 275-9442
NPI assigned
Apr 13, 2006
Last updated
Feb 2, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G46421 CA Primary

Addresses

Primary practice location

455 Oconnor Dr
Suite 210
San Jose, CA 95128-1633

Mailing address

455 Oconnor Dr
Suite 210
San Jose, CA 95128-1633
Phone (408) 995-5453

Other identifiers 1

IdentifierTypeStateIssuer
00G464210MedicaidCA

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
I20050328000648 CA Practitioner - Family Practice 4385544576 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Healthcare AllianceGroup PAC ID 6305748799, 334 clinicians
County of Santa ClaraGroup PAC ID 1254244973, 1,000 clinicians

Practice addresses (Care Compare)

455 Oconnor Dr
Suite 210
San Jose, CA 95128-1632
Phone (408) 995-5453

751 S Bascom Ave
San Jose, CA 95128-2604

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
County of Santa Clara Family Medicine CurrentSince Mar 8, 2017 Accepting new patients
County of Santa Clara Current Accepting new patients
University Healthcare Alliance CurrentSince Oct 1, 2015 Accepting new patients
County of Santa Clara CurrentSince Mar 8, 2017 Accepting new patients
Family Practice Medical Associates, Inc. Family Medicine Past Accepting new patients

Locations

50 E Hamilton Ave
Ste 280
Campbell, CA 95008
Phone (408) 227-2646

1300 Crane St
Menlo Park, CA 94025
Phone (510) 785-5000

4725 1st St
Ste 100
Pleasanton, CA 94566
Phone (925) 462-7060

455 Oconnor Dr
Ste 210
San Jose, CA 95128
Phone (408) 831-5744

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

Interoperability endpoints

  • Direct secure messaging: gkent10876@santaclaravalley.direct-ci.net
  • Direct secure messaging: gkent126652@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 12

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": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328140800000",
    "number": "1861456246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 OCONNOR DR",
            "address_2": "SUITE 210",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951281633",
            "telephone_number": "408-995-5453",
            "fax_number": "408-275-9442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 OCONNOR DR",
            "address_2": "SUITE 210",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951281633",
            "telephone_number": "408-995-5453",
            "fax_number": "408-275-9442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENT",
        "first_name": "GEORGE",
        "middle_name": "PETER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-13",
        "last_updated": "2012-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G46421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G464210",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.