Individual provider Active NPI

Daniel Andrew Nelson, M.D.

  • Emergency Medicine Physician
  • San Jose, CA
National Provider Identifier
1992933154
Registry record updated May 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A125049 Issued in CA
Practice address
751 S Bascom Ave
San Jose, CA 95128-2699
Phone
(408) 885-5000
NPI assigned
Jun 26, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 25MA09919200 NJ
Emergency Medicine Physician 207P00000X A125049 CA Primary

Addresses

Primary practice location

751 S Bascom Ave
San Jose, CA 95128-2699

Mailing address

1442 S Winchester Blvd
PMB 117
San Jose, CA 95128-4330
Phone (908) 319-2666

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130627000437 CA Practitioner - Emergency Medicine 0648419432 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Physicians Associates San Jose PCGroup PAC ID 8921344292, 131 clinicians

Practice addresses (Care Compare)

2105 Forest Ave
San Jose, CA 95128-1425
Phone (408) 947-2500

Hospital & facility affiliations

  • Santa Clara Valley Medical Center Hospital, San Jose, CA, CCN 050038

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA09919200NJMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Santa Clara CurrentSince May 25, 2019 Accepting new patients
Emergency Physicians Associates San Jose PC Emergency Medicine CurrentSince Jan 1, 2019 Accepting new patients
Emergency Physicians Associates Overhead Operating Account Dennis Belo Emergency Medicine CurrentSince May 1, 2017 Accepting new patients
County of Santa Clara Current Accepting new patients
County of Santa Clara CurrentSince May 25, 2019 Accepting new patients

Locations

9400 No Name Uno
Gilroy, CA 95020
Phone (408) 848-2000

225 N Jackson Ave
San Jose, CA 95116
Phone (408) 347-4051

1442 S Winchester Blvd
San Jose, CA 95128
Phone (510) 791-3430

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

2105 Forest Ave
San Jose, CA 95128
Phone (408) 947-2500

Interoperability endpoints

  • Direct secure messaging: dnelson125880@santaclaravalley.direct-ci.net

Organizations & group practices 5

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": "1245974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1992933154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1442 S WINCHESTER BLVD",
            "address_2": "PMB 117",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951284330",
            "telephone_number": "908-319-2666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 S BASCOM AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282699",
            "telephone_number": "408-885-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "DANIEL",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-26",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MA09919200",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A125049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.