NPIMap

Individual provider Active NPI

Andres A Marin, M.D.

  • Family Medicine Physician
  • Oakland, CA
National Provider Identifier
1083848014
Registry record updated Oct 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A107551 Issued in CA
Practice address
3451 East 12TH Street
2ND Floor
Oakland, CA 94601-3319
Phone
(510) 535-3319
Fax
(510) 535-4187
NPI assigned
May 5, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2010

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 A107551 CA Primary

Addresses

Primary practice location

3451 East 12TH Street
2ND Floor
Oakland, CA 94601-3319

Mailing address

1601 Fruitvale Ave.
Oakland, CA 94601
Phone (510) 535-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100928000554 CA Practitioner - Family Practice 4981720992 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, San Francisco School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
La Clinica de la Raza IncGroup PAC ID 1557258282, 130 clinicians

Practice addresses (Care Compare)

3451 E 12TH St
Oakland, CA 94601-3463
Phone (510) 535-3500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A107551CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of California SFGH Medical Group Current Accepting new patients
University of California SFGH Medical Group Family Medicine CurrentSince Jul 11, 2010 Accepting new patients
University of California SFGH Medical Group CurrentSince Jul 11, 2010 Accepting new patients
City & County of San Francisco Current Accepting new patients
La Clinica de la Raza Inc CurrentSince May 12, 2013 Accepting new patients
City and County of San Francisco CurrentSince Nov 10, 2019 Accepting new patients
La Clinica de la Raza Inc CurrentSince May 12, 2013 Accepting new patients
City & County of San Francisco CurrentSince Nov 10, 2019 Accepting new patients
Alta Bates Summit Medical Center Past Accepting new patients
La Clinica de la Raza, Inc. Past Accepting new patients

Locations

3451 E 12th St
Fl 2
Oakland, CA 94601
Phone (510) 535-3319

3451 E 12th St
Oakland, CA 94601
Phone (510) 535-3319

1001 Potrero Ave
Bldg 80
San Francisco, CA 94110
Phone (628) 206-8610

1001 Potrero Ave
San Francisco, CA 94110
Phone (415) 206-2305

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: amarin306637@direct.ochin.org

Organizations & group practices 11

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1241481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287100800000",
    "number": "1083848014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 FRUITVALE AVE.",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "94601",
            "telephone_number": "510-535-4000",
            "fax_number": "510-535-4128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3451 EAST 12TH STREET",
            "address_2": "2ND FLOOR",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946013319",
            "telephone_number": "510-535-3319",
            "fax_number": "510-535-4187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARIN",
        "first_name": "ANDRES",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-05",
        "last_updated": "2010-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A107551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.