Individual provider Active NPI

Janice Ortega-Santos Cooper, MSN, NP

  • Nurse Practitioner
  • Fremont, CA
National Provider Identifier
1972748648
Registry record updated May 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
657921 Issued in CA
Practice address
39180 Farwell Dr Ste 110
Fremont, CA 94538-1015
Phone
(510) 739-6520
NPI assigned
Dec 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 657921 CA Primary

Addresses

Primary practice location

39180 Farwell Dr Ste 110
Fremont, CA 94538-1015

Mailing address

400 Parnassus Ave Suite 311
San Francisco, CA 94112-0332
Phone (415) 353-2376

Other practice location 1

400 parnassus Ave Suite 311
San Francisco, CA 94112-0332
Phone (415) 353-2376

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090504000413 CA Practitioner - Nurse Practitioner 4183772007 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Orthopaedic Sports Specialists a Medical Corp.Group PAC ID 7113968181, 3 clinicians

Practice addresses (Care Compare)

39180 Farwell Dr
Suite 110
Fremont, CA 94538-1015
Phone (510) 739-6520

Hospital & facility affiliations

  • Washington Hospital Hospital, Fremont, CA, CCN 050195

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
17136CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Sports Specialists a Medical Corp CurrentSince May 14, 2019 Accepting new patients

Locations

39180 Farwell Dr
Ste 110
Fremont, CA 94538
Phone (510) 739-6520

550 S Winchester Blvd
Ste 320
San Jose, CA 95128

Organizations & group practices 1

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 1

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": "1228867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556841600000",
    "number": "1972748648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 PARNASSUS AVE SUITE 311",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941120332",
            "telephone_number": "415-353-2376",
            "fax_number": "415-353-2176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39180 FARWELL DR STE 110",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381015",
            "telephone_number": "510-739-6520"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 parnassus Ave Suite 311",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941120332",
            "country_code": "US",
            "telephone_number": "415-353-2376",
            "fax_number": "415-353-2176",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOPER",
        "first_name": "JANICE",
        "middle_name": "ORTEGA-SANTOS",
        "credential": "MSN, NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-10",
        "last_updated": "2019-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "657921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

Verify at the official NPI Registry.