Shama Ann Jesudason, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

C160378 Issued in CA

Practice address

2930 2ND Ave Ste 200
Marina, CA 93933-6244

Phone

(831) 582-2100

Fax

(831) 886-1529

NPI assigned

Jun 15, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Montage Medical Group

  • Internal Medicine Physician
  • Carmel, CA
  • NPI 1770710709
  Medicare reassignment NPD
• Monterey Hospitalist Medical Group

  • Internal Medicine Physician
  • Monterey, CA
  • NPI 1043321623
  Medicare reassignment NPD

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1881638575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WILSON RD STE 100",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939407885",
            "telephone_number": "831-649-1000",
            "fax_number": "831-649-4962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2930 2ND AVE STE 200",
            "city": "MARINA",
            "state": "CA",
            "postal_code": "939336244",
            "telephone_number": "831-582-2100",
            "fax_number": "831-886-1529"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 S Linn Ave",
            "address_purpose": "LOCATION",
            "city": "New Hampton",
            "state": "IA",
            "postal_code": "506592019",
            "country_code": "US",
            "telephone_number": "641-394-2151",
            "fax_number": "641-394-3150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JESUDASON",
        "first_name": "SHAMA",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "C160378",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0469916",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Crystal L Jackson
• Kendall K Jang, DDS
• Danny Jaramillo, COUNSELOR II
• Blue Phoenix Jauregui
• Jenny Garcia MD Inc
• Dingxin Jia
• Howard L. Jones, DDS
• Kaffia Jones
• Rosa Jones
• Vanessa L Jones, L.C.S.W.

• Family Medicine Physician in Marina, CA
• Providers in Marina, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.