Individual provider Active NPI

Michael Andre Lenoir, MD

  • Allergy Physician
  • Fremont, CA
National Provider Identifier
1023065760
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy PhysicianTaxonomy code 207KA0200X
License
C33136 Issued in CA
Practice address
3448 Mowry Ave
Fremont, CA 94538-1422
Phone
(510) 373-3000
Fax
(844) 965-9795
NPI assigned
May 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X C331360 CA
Pediatrics Physician 208000000X C331360 CA
Allergy Physician 207KA0200X C33136 CA Primary

Addresses

Primary practice location

3448 Mowry Ave
Fremont, CA 94538-1422

Mailing address

7677 Oakport St Ste 105
Oakland, CA 94621-1961
Phone (510) 993-0200

Other identifiers 1

IdentifierTypeStateIssuer
OOC13360MedicaidCA

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
I20071110000185 CA Practitioner - Allergy/ImmunologyPractitioner - Pediatric Medicine 3476641317 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/ImmunologyAlso: Pediatric Medicine
Education
University of Texas Medical Branch at Galveston, 1967
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jiva Health IncGroup PAC ID 5092115105, 46 clinicians

Practice addresses (Care Compare)

2182 E St
Concord, CA 94520-2012
Phone (925) 685-4228

5709 Market St
Suite 100
Oakland, CA 94608-2811
Phone (925) 685-4224

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C33136CAMDAllergy Physician
C331360CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jiva Health, Inc Internal Medicine CurrentSince Jul 1, 2024 Accepting new patients
Hill Physicians Medical Group - PPO Program Past Accepting new patients
Columbia Asthma & Allergy Clinic Past Accepting new patients
California Pacific Medical Group, Inc. Past Accepting new patients

Locations

2182 East St
Concord, CA 94520
Phone (925) 392-4731

1860 Mowry Ave
Ste 201
Fremont, CA 94538
Phone (510) 284-4100

7677 Oakport St
Ste 106
Oakland, CA 94621

2940 Summit St
Ste 1
Oakland, CA 94609
Phone (510) 834-4897

5709 Market St
Ste 100
Oakland, CA 94608
Phone (510) 654-4206

2940 Summit St
Ste 1B
Oakland, CA 94609
Phone (510) 834-4897

2940 Summit St
#1B
Oakland, CA 94609
Phone (510) 834-4897

7677 Oakport St
Ste 105
Oakland, CA 94621
Phone (510) 993-0200

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: mlenoir224381@hpmg.direct-ci.net
  • Direct secure messaging: mlenoir297322@direct.ochin.org

Organizations & group practices 4

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": "1148774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1023065760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7677 OAKPORT ST STE 105",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946211961",
            "telephone_number": "510-993-0200",
            "fax_number": "510-922-9224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3448 MOWRY AVE",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381422",
            "telephone_number": "510-373-3000",
            "fax_number": "844-965-9795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LENOIR",
        "first_name": "MICHAEL",
        "middle_name": "ANDRE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-28",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C331360",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "C331360",
            "primary": false
        },
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "CA",
            "license": "C33136",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OOC13360",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

Verify at the official NPI Registry.