Individual provider Active NPI

Summit Lucas Schreck

  • Technician
  • Hayward, CA
National Provider Identifier
1053151068
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
TechnicianTaxonomy code 374700000X
Practice address
22283 Main St
Hayward, CA 94541-4004
Phone
(510) 470-3752
NPI assigned
May 28, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Technician 374700000X Primary

Addresses

Primary practice location

22283 Main St
Hayward, CA 94541-4004

Mailing address

30 Fairway Dr
Novato, CA 94949-5904
Phone (415) 246-1950

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

NPI Registry JSON

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

{
    "created_epoch": "1716854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1053151068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 FAIRWAY DR",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949495904",
            "telephone_number": "415-246-1950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22283 MAIN ST",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945414004",
            "telephone_number": "510-470-3752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHRECK",
        "first_name": "SUMMIT",
        "middle_name": "LUCAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-05-28",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374700000X",
            "taxonomy_group": "",
            "desc": "Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hayward, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.