Ciaran Jacka, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

E4622 Issued in CA

Practice address

13847 E 14TH St Ste 210
San Leandro, CA 94578-2626

Phone

(510) 351-7552

Fax

(510) 351-6009

NPI assigned

Jun 8, 2006

Last updated

Apr 11, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

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 2

Specialty

PodiatryAlso: Orthopedic Surgery

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

East Bay Foot and Ankle Clinic IncGroup PAC ID 0345569307, 2 clinicians

Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Vision Home Health Care Home health agency, Concord, CA, CCN 058479
• Alta Bates Summit Medical Center Hospital, Oakland, CA, CCN 050043
• Alta Bates Summit Medical Center - Alta Bates Camp Hospital, Berkeley, CA, CCN 050305
• Eden Medical Center Hospital, Castro Valley, CA, CCN 050488

Merit-based Incentive Payment System (MIPS)

Final score

72.65 of 100Reported as group

Quality

26.53

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: cjacka141927@hisp.ehr.sutterhealth.org

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.

• East Bay Foot & Ankle Clinic Inc

  • Foot & Ankle Surgery Podiatrist
  • San Leandro, CA
  • NPI 1194118851
  Medicare reassignment Care Compare group NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299
  Medicare reassignment Care Compare group NPD
• Ciaran Jacka DPM Inc

  • Podiatric Clinic/Center
  • San Pablo, CA
  • NPI 1699496927
  NPD Authorized official
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Stockton, CA
  • NPI 1548343510
  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD
• Agnews Community Clinic

  • Developmental Disabilities Clinic/Center
  • San Jose, CA
  • NPI 1710148515
  NPD (past)
• California Avant-Garde Physicians

  dba Golden Gate Foot and Ankle

  • Foot & Ankle Surgery Podiatrist
  • Sonoma, CA
  • NPI 1578075982
  NPD (past)
• California Pacific Medical Group, Inc.

  dba Brown & Toland Medical Group

  • Multi-Specialty Clinic/Center
  • Oakland, CA
  • NPI 1275002453
  NPD (past)
• State of California - Department of Developmental Services

  • General Acute Care Hospital
  • Eldridge, CA
  • NPI 1851344220
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Excellife Inc.

  dba Vision Home Health Care

  • Home Health Agency
  • Concord, CA
  • NPI 1386306132
  Care Compare affiliation
• Sutter Bay Hospitals

  dba Eden Medical Center

  • General Acute Care Hospital
  • Castro Valley, CA
  • NPI 1063812907
  Care Compare affiliation
• Sutter Bay Hospitals

  dba Alta Bates Summit Medical Center - Summit Campus

  • General Acute Care Hospital
  • Oakland, CA
  • NPI 1295181477
  Care Compare affiliation
• Sutter Bay Hospitals

  dba Alta Bates Summit Medical Center - Alta Bates Campus

  • General Acute Care Hospital
  • Berkeley, CA
  • NPI 1639523004
  Care Compare affiliation

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649635200000",
    "number": "1891735445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13847 E 14TH ST STE 210",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945782626",
            "telephone_number": "510-351-7552",
            "fax_number": "510-351-6009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13847 E 14TH ST STE 210",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945782626",
            "telephone_number": "510-351-7552",
            "fax_number": "510-351-6009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKA",
        "first_name": "CIARAN",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "CA",
            "license": "E4622",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E4622",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E46220",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2500 Merced Street",
            "city": "San Leandro",
            "state": "CA",
            "country_code": "US",
            "postal_code": "94577",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2500 Merced Street",
            "city": "San Leandro",
            "state": "CA",
            "country_code": "US",
            "postal_code": "94577",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Louis Albert Ivey III, M.D.
• Kimberley Ivory
• Tony Iwane
• John J Jaber, DDS
• Veronika Jablonski
• Kelli Tracy Jackman, MPT
• Ebony Jackson
• Jacqueline L Jackson
• Jazmine Jackson
• Teneva Jackson

• Foot & Ankle Surgery Podiatrist in San Leandro, CA
• Providers in San Leandro, CA by specialty
• Foot & Ankle Surgery Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.