Individual provider Active NPI

Ellen C Morrissey, MD

  • Nephrology Physician
  • Berkeley, CA
National Provider Identifier
1003913781
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
G55797 Issued in CA
Practice address
2905 Telegraph Ave
Berkeley, CA 94705-2063
Phone
(510) 841-0411
Fax
(510) 845-5030
NPI assigned
Sep 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X G55797 CA Primary

Addresses

Primary practice location

2905 Telegraph Ave
Berkeley, CA 94705-2063

Mailing address

2905 Telegraph Ave
Berkeley, CA 94705-2063
Phone (510) 841-0411

Other identifiers 1

IdentifierTypeStateIssuer
00G557970MedicaidCA

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
I20080624000268 CA Practitioner - NephrologyPractitioner - Internal Medicine 1759398852 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G55797CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East Bay Nephrology Medical Group, Inc. Nephrology Current Accepting new patients
East Bay Nephrology Medical Group, Inc. Nephrology CurrentSince Jan 18, 1988 Accepting new patients
Alameda Health System Current Accepting new patients
Alameda Health System CurrentSince Mar 24, 2012 Accepting new patients
Alameda Health System CurrentSince Mar 24, 2012 Accepting new patients
Total Renal Care Inc PastSince Feb 1, 2019 Accepting new patients

Locations

2905 Telegraph Ave
Berkeley, CA 94705
Phone (510) 841-0411

3043 Summit St
Oakland, CA 94609
Phone (510) 451-6840

1411 E 31st St
Oakland, CA 94602
Phone (510) 437-4323

14020 San Pablo Ave
Ste A
San Pablo, CA 94806
Phone (510) 235-1057

125 Hospital Dr
Vallejo, CA 94589
Phone (707) 642-7510

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: emorrissey14408@alamedahs.direct-ci.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1003913781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2905 TELEGRAPH AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052063",
            "telephone_number": "510-841-0411",
            "fax_number": "510-845-5030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2905 TELEGRAPH AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052063",
            "telephone_number": "510-841-0411",
            "fax_number": "510-845-5030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRISSEY",
        "first_name": "ELLEN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-17",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "G55797",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G557970",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.