NPIMap

Organization Active NPI

Pontine Incorporated

  • Anesthesiology Physician
  • San Ramon, CA
National Provider Identifier
1053757609
Registry record updated May 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
PONTINE INCORPORATED
Practice address
12935 Alcosta Blvd Unit 2037
San Ramon, CA 94583-6098
Phone
(510) 225-9090
NPI assigned
May 21, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2024

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

Authorized official

Name
Dr. Yusuf Haroon Ahmad, MDNPI 1104020262
Title
President
Phone
(510) 225-9090

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary
Medical Specialty Clinic/Center 261QM2500X A116785 CA

Addresses

Primary practice location

12935 Alcosta Blvd Unit 2037
San Ramon, CA 94583-6098

Mailing address

12935 Alcosta Blvd Unit 2037
San Ramon, CA 94583-6098
Phone (510) 225-9090

Other identifiers 1

IdentifierTypeStateIssuer
A116785OtherCAMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130722000133 CA Part B Supplier - Clinic/Group Practice 1052550266 Receives reassigned benefits from 27 practitioners
Practice locations: Fremont, CA; Pleasanton, CA; Tracy, CA; Vacaville, CA

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

12935 Alcosta Blvd
Unit 2037
San Ramon, CA 94583
Phone (510) 225-9090

2160 W Grant Line Rd
Ste 120
Tracy, CA 95377
Phone (209) 832-2095

498 N Wiget Ln
Walnut Creek, CA 94598
Phone (925) 933-3600

Practitioners & affiliated clinicians

Practitioners 28

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1369094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715904000000",
    "number": "1053757609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12935 ALCOSTA BLVD UNIT 2037",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945836098",
            "telephone_number": "510-225-9090",
            "fax_number": "510-544-0055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12935 ALCOSTA BLVD UNIT 2037",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945836098",
            "telephone_number": "510-225-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PONTINE INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-21",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A",
        "authorized_official_last_name": "AHMAD",
        "authorized_official_first_name": "YUSUF",
        "authorized_official_middle_name": "HAROON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "510-225-9090",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "CA",
            "license": "A116785",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "A116785",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Ramon, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.