NPIMap

Organization Active NPI

Alliance Healthcare Services Inc

  • Radiology Clinic/Center
  • Fremont, CA
National Provider Identifier
1003983685
Registry record updated Jul 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
License
6640-30 Issued in CA
Legal business name
ALLIANCE HEALTHCARE SERVICES INC
Practice address
2500 Mowry Ave
Suite 170
Fremont, CA 94538
Phone
(510) 608-1380
NPI assigned
Nov 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2023

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

Authorized official

Name
Laura Kassa
Title
Sr Vice President
Phone
(904) 300-2777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X 6640-30 CA Primary

Addresses

Primary practice location

2500 Mowry Ave
Suite 170
Fremont, CA 94538

Mailing address

8300 W Sunrise Blvd
Plantation, FL 33322-5406

Other identifiers 3

IdentifierTypeStateIssuer
ZZZ55650ZOtherCABLUE SHIELD OF CA
EXE70092FMedicaidCA
ZZZ08999ZOtherCABLUE SHIELD OF CA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121112000405 CA Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 4284546870 Practice locations: Fremont, CA

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

2500 Mowry Ave
Ste 170
Fremont, CA 94538
Phone (510) 608-1380

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690156800000",
    "number": "1003983685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8300 W SUNRISE BLVD",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333225406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 MOWRY AVE",
            "address_2": "SUITE 170",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "94538",
            "telephone_number": "510-608-1380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLIANCE HEALTHCARE SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A",
        "authorized_official_last_name": "KASSA",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "SR VICE PRESIDENT",
        "authorized_official_telephone_number": "904-300-2777"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "CA",
            "license": "6640-30",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA",
            "identifier": "ZZZ55650Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "EXE70092F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA",
            "identifier": "ZZZ08999Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.