Active NPI
Asano Floy Fertig, MD
- Family Medicine Physician
- Oakland, CA
National Provider Identifier
1013017268
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- G52878
- Practice address
- 1515 Fruitvale Ave
Oakland, CA 94601-2322 - Phone
- (510) 535-6300
- Fax
- (510) 535-5802
- NPI assigned
- Sep 25, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | G52878 | CA | Primary |
Addresses
Primary practice location
1515 Fruitvale Ave
Oakland, CA 94601-2322
Mailing address
1601 Fruitvale Ave
Oakland, CA 94601-2322
Phone (510) 535-4000
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZZ72118Z | Other | CA | MEDICARE PART B |
| FHC71087F | Medicaid | CA | |
| HAP71087F | Other | CA | FPACT |
| 05-1821 | Other | CA | MEDICARE PART A |
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G52878 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| La Clinica de la Raza Inc | Past | Accepting new patients | |
| La Clinica de la Raza Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba TechniClinic
- Federally Qualified Health Center (FQHC)
- Oakland, CA
- NPI 1013085778
-
dba Tiger Health Clinic
- Federally Qualified Health Center (FQHC)
- Oakland, CA
- NPI 1619056926
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1195776000000",
"number": "1013017268",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1601 FRUITVALE AVE",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946012322",
"telephone_number": "510-535-4000",
"fax_number": "510-535-4128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1515 FRUITVALE AVE",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946012322",
"telephone_number": "510-535-6300",
"fax_number": "510-535-5802"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERTIG",
"first_name": "ASANO",
"middle_name": "FLOY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-25",
"last_updated": "2007-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "G52878",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PART B",
"identifier": "ZZZ72118Z",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "FHC71087F",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FPACT",
"identifier": "HAP71087F",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PART A",
"identifier": "05-1821",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.