Provider Information Update
It is important that we have the most up to date information about your practice. Any change in your provider information must be reported to Jade Health Care Medical Group’s Contracting Dept in writing as soon as possible. Some examples of these changes include practice location, phone number, tax identification number, claims payment address, hours of operation, status as open to newly assigned members (for Primary Care Physicians), affiliated or covering physicians, physician assistants and nurse practitioners.
Please complete the Provider Information Change Form and sent it back to us via US Mail or Email:
Provider Information Change Form (PDF)
Jade Health Care Medical Group
Attn: Contracts Department
445 Grant Avenue, Suite 200
San Francisco, CA 94108