Individual provider Active NPI

Sharad Kumar Kohli, M.D.

  • Family Medicine Physician
  • Berkeley, CA
National Provider Identifier
1013969088
Registry record updated Jan 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
84508 Issued in CA
Practice address
2031 6TH St
West Berkeley Family Practice
Berkeley, CA 94710-2006
Phone
(510) 981-4234
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 84508 CA Primary

Addresses

Primary practice location

2031 6TH St
West Berkeley Family Practice
Berkeley, CA 94710-2006

Mailing address

2031 6TH St
West Berkeley Family Practice
Berkeley, CA 94710-2006
Phone (510) 981-4234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20180530002786 TX Practitioner - Family Practice 0244224855 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
84508CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
People'S Community Clinic, Inc. CurrentSince Apr 2, 2018 Accepting new patients
Peoples Community Clinic Inc Current Accepting new patients

Locations

1101 Camino La Costa
Austin, TX 78752
Phone (512) 478-4939

10335 US Highway 290 E
Bldg 35
Manor, TX 78653
Phone (512) 478-4939

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325721600000",
    "number": "1013969088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2031 6TH ST",
            "address_2": "WEST BERKELEY FAMILY PRACTICE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947102006",
            "telephone_number": "510-981-4234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2031 6TH ST",
            "address_2": "WEST BERKELEY FAMILY PRACTICE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947102006",
            "telephone_number": "510-981-4234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOHLI",
        "first_name": "SHARAD",
        "middle_name": "KUMAR",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2012-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "84508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.