NPIMap

Individual provider Active NPI

Jesse McKenney, MD

  • Anatomic Pathology Physician
  • Stanford, CA
National Provider Identifier
1881784379
Registry record updated Jun 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology PhysicianTaxonomy code 207ZP0101X
License
A81354 Issued in CA
Practice address
300 Pasteur Dr # L235
Stanford, CA 94305-2200
Phone
(650) 723-7975
NPI assigned
Oct 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology Physician 207ZP0101X A81354 CA Primary

Addresses

Primary practice location

300 Pasteur Dr # L235
Stanford, CA 94305-2200

Mailing address

300 Pasteur Dr # L235
Stanford, CA 94305-2200
Phone (650) 721-1180

Other identifiers 2

IdentifierTypeStateIssuer
P00136815OtherARRAILROAD MEDICARE
154802001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20120918000293 OH Practitioner - Pathology 9537050406 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Texas Southwestern Medical School at Dallas, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

18901 Lake Shore Blvd
Euclid, OH 44119-1078
Phone (216) 531-9000

8950 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-8950

9500 Euclid Ave
Cleveland, OH 44195-0001

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A81354CAMDAnatomic Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients
The Cleveland Clinic Foundation CurrentSince Aug 12, 2012 Accepting new patients
Wooster Clinic, LLC CurrentSince Jan 1, 2015 Accepting new patients
The Cleveland Clinic Foundation CurrentSince Aug 12, 2012 Accepting new patients
Fairview Hospital Past Accepting new patients
Stanford Hospital and Clinics Past Accepting new patients
Lutheran Hospital Past Accepting new patients
Cleveland Clinic Health System - East Region Past Accepting new patients
Cleveland Clinic Avon Hospital Past Accepting new patients
South Pointe Hospital Past Accepting new patients

Locations

300 Pasteur Dr
Stanford, CA 94305
Phone (650) 498-5710

300 Pasteur Dr
#H2110
Stanford, CA 94305
Phone (650) 723-7211

300 Pasteur Dr
#L235
Stanford, CA 94305
Phone (650) 723-5252

300 Pasteur Dr
Rm H2110
Stanford, CA 94305
Phone (650) 723-7211

300 Pasteur Dr
#5627
Stanford, CA 94305
Phone (415) 723-5252

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

18901 Lake Shore Blvd
Euclid, OH 44119
Phone (216) 531-9000

1740 Cleveland Rd
Wooster, OH 44691
Phone (330) 287-4500

Interoperability endpoints

  • Direct secure messaging: jmckenney166285@direct.ccf.org

Organizations & group practices 10

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 5

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213056000000",
    "number": "1881784379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR # L235",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "650-721-1180",
            "fax_number": "650-725-7409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR # L235",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "650-723-7975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENNEY",
        "first_name": "JESSE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2008-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "CA",
            "license": "A81354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00136815",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154802001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stanford, CA

Sources for this page

Verify at the official NPI Registry.