Active NPI
Amater Zeale Traylor Jr., MD
- Ophthalmology Physician
- Oakland, CA
National Provider Identifier
1033178876
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- C32496
- Practice address
- 5682 Adeline Street
Oakland, CA 94608-2804 - Phone
- (510) 655-5385
- Fax
- (510) 601-9351
- NPI assigned
- Mar 21, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | C32496 | CA | Primary |
Addresses
Primary practice location
5682 Adeline Street
Oakland, CA 94608-2804
Mailing address
5682 Adeline Street
Oakland, CA 94608-2804
Phone (510) 655-5385
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000C324960 | Medicaid | CA |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100422000361 | CA | Practitioner - Ophthalmology | 3971630914 | Practice locations: Oakland, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32496 | CA | MD | Dentist |
| C32496 | CA | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142899200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352246400000",
"number": "1033178876",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5682 ADELINE STREET",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946082804",
"telephone_number": "510-655-5385",
"fax_number": "510-594-0121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5682 ADELINE STREET",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946082804",
"telephone_number": "510-655-5385",
"fax_number": "510-601-9351"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRAYLOR",
"first_name": "AMATER",
"middle_name": "ZEALE",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-03-21",
"last_updated": "2012-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "CA",
"license": "C32496",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000C324960",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
- Trauma & Stress Recovery, a Medical Group Inc. (Trauma & Stress Recovery Center)
- Kelly Trautman, OTR, MOT
- Travelers Aid Society of Alameda County, Inc.
- Graham Travenick, BCBA
- Bayla Travis
- Theresa Traynor
- Marsha J Treadwell, PHD
- Treble Health Audiology Services, P.C.
- Erin Trefny
- Oscar Trejo Baide, MSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.