Individual provider Active NPI

Elizabeth Macera, N.P.

  • Nurse Practitioner
  • San Leandro, CA
National Provider Identifier
1003979295
Registry record updated Oct 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN221647 Issued in CA
Practice address
2500 Merced St
San Leandro, CA 94577-4201
Phone
(510) 454-1000
Fax
(415) 576-8899
NPI assigned
Dec 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN221647 CA Primary

Addresses

Primary practice location

2500 Merced St
San Leandro, CA 94577-4201

Mailing address

2500 Merced St
San Leandro, CA 94577-4201
Phone (510) 454-1000

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ28811ZMedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN221647CAMDNurse Practitioner

Interoperability endpoints

  • Direct secure messaging: elizabeth.macera.1@17742.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443744000000",
    "number": "1003979295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 MERCED ST",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774201",
            "telephone_number": "510-454-1000",
            "fax_number": "415-576-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 MERCED ST",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774201",
            "telephone_number": "510-454-1000",
            "fax_number": "415-576-8899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACERA",
        "first_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-18",
        "last_updated": "2015-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "RN221647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ28811Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Leandro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.