DBA: PEDIATRIC ASSOCIATES
NPI 1134279904
Pediatrics in San Jose, CA

NPI Status: Active since January 12, 2007

Contact Information

2577 SAMARITAN DR
SUITE 830
SAN JOSE, CA
ZIP 95124
Phone: (408) 356-1319
Fax: (408) 356-6296

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  • Organization
  • Pediatrics
  • CLIA Number: 05D0951359
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 09-15-2026

About DBA: PEDIATRIC ASSOCIATES

This page provides the complete NPI Profile along with additional information for Dba: Pediatric Associates, a pediatrician established in San Jose, California operating as a Pediatrics. The healthcare provider is registered in the NPI registry with number 1134279904 assigned on January 2007. The practitioner's primary taxonomy code is 208000000X. The provider is registered as an organization and their NPI record was last updated 18 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's is doing business as Dba: Pediatric Associates. The authorized official of this NPI record is Bryan J Drucker Md (Ceo)

NPI
1134279904
Provider Legal Name
PA MEDICAL GROUP INC
Other Organization Name
DBA: PEDIATRIC ASSOCIATES
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
2577 SAMARITAN DR SUITE 830 SAN JOSE, CA 95124
Location Phone
(408) 356-1319
Location Fax
(408) 356-6296
Mailing Address
2577 SAMARITAN DR SUITE 830 SAN JOSE, CA 95124
Mailing Phone
(408) 356-1319
Mailing Fax
(408) 356-6296
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
01-12-2007
Last Update Date
07-16-2008
Code Navigator

A pediatrician like Dba: Pediatric Associates is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Pediatrics

Taxonomy Code
208000000X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

BRYAN J DRUCKER MD

Authorized Official Title
CEO
Authorized Official Phone
(408) 356-1319

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
G84517OTHER (01)CASTATE LICENSE
A51788OTHER (01)CASTATE LICENSE
A70876OTHER (01)CASTATE LICENSE
G77403OTHER (01)CASTATE LICENSE
A64948OTHER (01)CASTATE LICENSE

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
05D0951359
Facility Type
Physician Office
Certificate Effective Date
September 16, 2024
Certificate Expiration Date
September 15, 2026
Laboratory Director
JERINA KAPOOR MD
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Dba: Pediatric Associates to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1134279904, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 66. The final step is to find the difference between that total and the next multiple of ten (70 - 66 = 4).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
3
Doubled → 6
Pos 4
4
Unchanged
Pos 5
2
Doubled → 4
Pos 6
7
Unchanged
Pos 7
9
Doubled → 18 → 1 + 8
Pos 8
9
Unchanged
Pos 9
0
Doubled → 0
Check
4
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 3 → 6 2 → 4 9 → 18 → 9 0 → 0

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 6 + 4 + 4 + 7 + 1 + 8 + 9 + 0 + 24 = 66

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 66 is 70. The difference is the calculated check digit.

70 - 66 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1134279904.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Ophthalmology
2577 SAMARITAN DR, SUITE 740
SAN JOSE, CA 95124
Pediatrics
2577 SAMARITAN DR, SIUTE 720
SAN JOSE, CA 95124
Pediatrics (Pediatric Gastroenterology)
2577 SAMARITAN DR, STE 815
SAN JOSE, CA 95124
Pediatrics
2577 SAMARITAN DR, SUITE 720
SAN JOSE, CA 95124
Pediatrics (Adolescent Medicine)
2577 SAMARITAN DR, SUITE 830
SAN JOSE, CA 95124
Pediatrics
2577 SAMARITAN DR, SUITE830
SAN JOSE, CA 95124
Physical Medicine & Rehabilitation
2577 SAMARITAN DR, SUITE 855F
SAN JOSE, CA 95124
Psychiatry & Neurology (Neurology)
2577 SAMARITAN DR, SUITE #840
SAN JOSE, CA 95124
Pediatrics
2577 SAMARITAN DR, SUITE # 725
SAN JOSE, CA 95124
Pediatrics
2577 SAMARITAN DR, SUITE # 725
SAN JOSE, CA 95124
Pediatrics
2577 SAMARITAN DR, SUITE 745
SAN JOSE, CA 95124
Specialist
2577 SAMARITAN DR, SUITE 710
SAN JOSE, CA 95124
Specialist
2577 SAMARITAN DR, SUITE 710
SAN JOSE, CA 95124
Neurological Surgery
2577 SAMARITAN DR, SUITE 710
SAN JOSE, CA 95124
Specialist
2577 SAMARITAN DR, SUITE 710
SAN JOSE, CA 95124
Specialist
2577 SAMARITAN DR, SUITE 710
SAN JOSE, CA 95124
Eyewear Supplier
2577 SAMARITAN DR, SUITE 740
SAN JOSE, CA 95124
Pediatrics
2577 SAMARITAN DR, SUITE# 725
SAN JOSE, CA 95124
Pediatrics (Pediatric Allergy/Immunology)
2577 SAMARITAN DR, SUITE 860
SAN JOSE, CA 95124
Clinic/Center (Ophthalmologic Surgery)
2577 SAMARITAN DR, SUITE 732
SAN JOSE, CA 95124

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1134279904, enumerated as an "organization" on January 12, 2007.

The provider is located at 2577 SAMARITAN DR SUITE 830 SAN JOSE, CA 95124 and the phone number is (408) 356-1319.

Pediatrics with taxonomy code 208000000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.