Jonathan David Kawulok Updike, MD, MPH
Individual provider Active NPI Psychiatry Physician · Palo Alto, CA
NPI 1861995649 · NPPES record last updated Nov 18, 2024
Key facts
- NPI
- 1861995649
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- A174976 (CA)
- Practice address
- 725 Welch Rd
Palo Alto, CA 94304-1601 - Phone
- (650) 497-8000
- NPI assigned
- Mar 17, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 9
Medicare Care Compare profile
- Specialty
- Psychiatry
- Education
- Columbia University College of Physicians and Surgeons, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Stanford Health Care
Kima-W Medical Center
Practice addresses (Care Compare)
300 Pasteur Dr
Stanford, CA 94305-2200
Phone (650) 723-4000
535 Airport Rd
Hoopa, CA 95546-9615
Phone (530) 625-4261
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240815000351 | CA | Practitioner - Psychiatry | 0648718130 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A174976 | CA | MD | Child & Adolescent Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stanford Health Care | Current | Accepting new patients | |
| K'Ima:W Medical Center | Current |
Accepting new patients | |
| LPCH Medical Group Div of Lucile | Current |
Accepting new patients | |
| Stanford Health Care | Current |
Accepting new patients | |
| Stanford Health Care | Current |
Accepting new patients | |
| K'Ima:W Medical Center | Current |
Accepting new patients |
Locations
401 Quarry Rd
Palo Alto, CA 94304
Phone (650) 498-9111
725 Welch Rd
Palo Alto, CA 94304
Phone (650) 497-8979
300 Pasteur Dr
Stanford, CA 94305
Phone (650) 498-5710
Interoperability endpoints
- jupdike216003@direct.stanfordhealthcare.org
- jupdike661287@hisp.ehr.sutterhealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | A174976 | CA | |
| Psychiatry Physician | 2084P0800X | A174976 | CA | Yes |
Addresses
Primary practice location
725 Welch Rd
Palo Alto, CA 94304-1601
Mailing address
725 Welch Rd
Palo Alto, CA 94304-1601
Phone (650) 497-8000
Other practice location 1
401 Quarry Road
Stanford, CA 94305
Phone (650) 725-5591
Other providers in Palo Alto, CA
- Ndidi Ifeoma Unaka
- Ayce Dikmen Unal
- Patrick Unemori
- Alexander Ungewickell
- Anirood Ramaprasad Unni
- Prerna Uppal
- John Urbanowicz
- Urbino Physical Therapy P.C.
- Ruby Calungcagin Urbino
- Kamran Urgun
All providers in Palo Alto, CA · Psychiatry Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 18, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.