Active NPI
James William Tetrud, MD
- Neurology Physician
- Palo Alto, CA
National Provider Identifier
1942228713
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- G28154
- Practice address
- 300 Pasteur Dr
Palo Alto, CA 94305-2200 - Phone
- (650) 723-4000
- Fax
- (650) 497-8000
- NPI assigned
- Jul 18, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | G28154 | CA | Primary |
Addresses
Primary practice location
300 Pasteur Dr
Palo Alto, CA 94305-2200
Mailing address
300 Pasteur Dr
Stanford, CA 94305-2200
Phone (650) 723-4000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G28154 | Other | CA | MED LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28154 | CA | MD | Social Worker |
| G28154 | CA | MD | Neurology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430352000000",
"number": "1942228713",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 PASTEUR DR",
"city": "STANFORD",
"state": "CA",
"postal_code": "943052200",
"telephone_number": "650-723-4000",
"fax_number": "650-498-5840"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 PASTEUR DR",
"city": "PALO ALTO",
"state": "CA",
"postal_code": "943052200",
"telephone_number": "650-723-4000",
"fax_number": "650-497-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TETRUD",
"first_name": "JAMES",
"middle_name": "WILLIAM",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-18",
"last_updated": "2015-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "CA",
"license": "G28154",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MED LICENSE",
"identifier": "G28154",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Palo Alto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.