Individual provider Active NPI

Karl Jeffries, MD

  • Psychiatry Physician
  • Albany, CA
National Provider Identifier
1922282938
Registry record updated Nov 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A101157 Issued in CA
Practice address
910 Tulare Ave
Albany, CA 94707-2112
Phone
(510) 549-2006
NPI assigned
Dec 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A101157 CA Primary

Addresses

Primary practice location

910 Tulare Ave
Albany, CA 94707-2112

Mailing address

910 Tulare Ave
Albany, CA 94707-2112
Phone (510) 549-2006

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
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
I20130318000337 VT Practitioner - Psychiatry 8527235621 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of California, San Francisco School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brattleboro RetreatGroup PAC ID 7012828908, 61 clinicians

Practice addresses (Care Compare)

PO Box
Suite 803
Brattleboro, VT 05302-0803

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A101157CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brattleboro Retreat CurrentSince Jan 7, 2013 Accepting new patients
Rutland Hospital, Inc. CurrentSince Dec 15, 2022 Accepting new patients
Rutland Hospital, Inc. Past Accepting new patients

Locations

1 Anna Marsh Ln
Dummerston, VT 05301

22 Anna Marsh Ln
Dummerston, VT 05301
Phone (802) 258-3700

51 Tennis Way
East Dorset, VT 05253
Phone (802) 366-8195

160 Allen St
Rutland, VT 05701

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1198713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320105600000",
    "number": "1922282938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 TULARE AVE",
            "city": "ALBANY",
            "state": "CA",
            "postal_code": "947072112",
            "telephone_number": "510-549-2006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 TULARE AVE",
            "city": "ALBANY",
            "state": "CA",
            "postal_code": "947072112",
            "telephone_number": "510-549-2006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFRIES",
        "first_name": "KARL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-27",
        "last_updated": "2011-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A101157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, CA

Sources for this page

Verify at the official NPI Registry.