Individual provider Active NPI

Sejal Ashok Jhatakia, M.D.

  • Internal Medicine Physician
  • San Leandro, CA
National Provider Identifier
1871577312
Registry record updated Dec 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A88424 Issued in CA
Practice address
13847 E 14TH St
#217
San Leandro, CA 94578-2632
Phone
(510) 483-2555
Fax
(510) 483-1856
NPI assigned
Nov 29, 2005
Last updated
Dec 13, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2021

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 A88424 CA Primary

Addresses

Primary practice location

13847 E 14TH St
#217
San Leandro, CA 94578-2632

Mailing address

6380 Clark Ave
Dublin, CA 94568-3036
Phone (925) 875-1677

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070126000424 CA Practitioner - Hematology/OncologyPractitioner - Internal Medicine 3072514405 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Internal Medicine
Education
University of California, Geffen School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

250 Hospital Pkwy
San Jose, CA 95119-1103
Phone (408) 972-3000

280 Hospital Pkwy
San Jose, CA 95119-1103
Phone (408) 972-3000

700 Lawrence Expy
Santa Clara, CA 95051-5173
Phone (408) 851-1000

710 Lawrence Express Way
Santa Clara, CA 95051-5173
Phone (408) 851-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A88424CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc Internal Medicine Current Accepting new patients
Permanente Medical Group Inc Internal Medicine CurrentSince Nov 13, 2011 Accepting new patients
Permanente Medical Group, Inc CurrentSince Nov 13, 2011 Accepting new patients

Locations

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

250 Hospital Pkwy
San Jose, CA 95119
Phone (408) 972-6320

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

Organizations & group practices 3

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 1

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": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639353600000",
    "number": "1871577312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6380 CLARK AVE",
            "city": "DUBLIN",
            "state": "CA",
            "postal_code": "945683036",
            "telephone_number": "925-875-1677",
            "fax_number": "925-875-0826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13847 E 14TH ST",
            "address_2": "#217",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945782632",
            "telephone_number": "510-483-2555",
            "fax_number": "510-483-1856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JHATAKIA",
        "first_name": "SEJAL",
        "middle_name": "ASHOK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-29",
        "last_updated": "2021-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A88424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "250 Hospital Pkwy",
            "city": "San Jose",
            "state": "CA",
            "country_code": "US",
            "postal_code": "951191103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Leandro, CA

Sources for this page

Verify at the official NPI Registry.