KAISER, JAY A (MD)

Provider Demographics

• NPI: 1275519001
• Name: KAISER, JAY A (MD)
• Entity Type: Individual
• Prefix: DR
• First Name: JAY
• Middle Name: A
• Last Name: KAISER
• Gender: M
• Credentials: MD
• Mailing Address - Street 1: PO BOX 6102
• Mailing Address - City: NOVATO
• Mailing Address - State: CA
• Mailing Address - Zip Code: 94948-6102
• Mailing Address - Country: US
• Mailing Address - Phone: 415-884-3418
• Mailing Address - Fax: 415-883-8082
• Practice Address - Street 1: 1260 S ELISEO DR
• Practice Address - Street 2: SUITE 100
• Practice Address - City: GREENBRAE
• Practice Address - State: CA
• Practice Address - Zip Code: 94904-2009
• Practice Address - Country: US
• Practice Address - Phone: 415-461-9033
• Practice Address - Fax: 415-883-8082
• Is Sole Proprietor?: No
• Enumeration Date: 2005-12-22
• Last Update Date: 2020-05-15

Provider Licenses

State	License ID	Taxonomies
AZ	33865	2085R0202X
AK	3882	2085R0202X
CO	30660	2085R0202X
MT	67	2085R0202X
NJ	MA72104	2085R0202X
NY	215258-1	2085R0202X
OH	35-06-3886-K	2085R0202X
OK	21480	2085R0202X
WA	MD00032583	2085R0202X
NV	SP079	2085R0202X
NE	24392	2085R0202X
TX	TM00056	2085R0202X
CA	G25290	2085R0202X
IL	036-103761	2085R0202X
HI	13079	2085R0202X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization
Yes	2085R0202X	Allopathic & Osteopathic Physicians	Radiology	Diagnostic Radiology

Provider Identifiers

State	Identifier ID	ID Type	Issuer
OK	200094370A	Medicaid
CA	300121788	Other	RAILROAD MEDICARE
WA	8169666	Medicaid
AZ	867632	Medicaid
CA	00G252900	Medicaid
WA	0144891	Other	L&I
WA	300123270	Other	RAILROAD MEDICARE
WA	8933499	Other	L&I CVCP
NJ	8940606	Medicaid
NV	1275519001	Medicaid
CO	1306604	Medicaid
NJ	8940606	Medicaid
CA	BY169Y	Medicare PIN
CO	CO300372	Medicare PIN
CA	00G2529013	Medicare PIN
WA	0144891	Other	L&I
NV	1275519001	Medicaid
CA	BY169S	Medicare PIN
CA	BY169T	Medicare PIN
CA	BY169X	Medicare PIN
NV	V105003	Medicare PIN
NV	V105276	Medicare PIN
WA	8169666	Medicaid
CA	BY169P	Medicare PIN
CA	BY169R	Medicare PIN
CA	BY169U	Medicare PIN
CA	00G2529015	Medicare PIN
WA	8933499	Other	L&I CVCP
AZ	867632	Medicaid
CA	BY169V	Medicare PIN
HI	CO202Z	Medicare PIN
CA	00G2529018	Medicare PIN
CA	300121788	Other	RAILROAD MEDICARE
NE	281818	Medicare PIN
WA	AB07764	Medicare PIN
CA	BY169N	Medicare PIN
CA	BY169W	Medicare PIN
AZ	Z110178	Medicare PIN
CA	00G252909	Medicare PIN
CA	00G2529021	Medicare PIN
CA	00G2529019	Medicare PIN
CA	00G2529017	Medicare PIN
CA	00G2529016	Medicare PIN