NPIMap

Individual provider Active NPI

Anthony E Allen, M.D.

  • Internal Medicine Physician
  • Berkeley, CA
National Provider Identifier
1104846054
Registry record updated Aug 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A73148 Issued in CA
Practice address
2512 Telegraph Ave
Ste 350
Berkeley, CA 94704-2918
Phone
(415) 420-4325
NPI assigned
Jul 20, 2006
Last updated
Aug 3, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A73148 CA Primary

Addresses

Primary practice location

2512 Telegraph Ave
Ste 350
Berkeley, CA 94704-2918

Mailing address

2512 Telegraph Ave
Ste 350
Berkeley, CA 94704-2918
Phone (415) 420-4325

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
I20070207000510 CA Practitioner - Internal Medicine 5496757296 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of South Florida College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2512 Telegraph Ave
Suite 350
Berkeley, CA 94704-2918
Phone (415) 509-5243

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
77.45 of 100Reported as individual
Quality
51.27
Improvement activities
40
Cost
56.46

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A73148CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Skilledmd, Inc. CurrentSince Mar 24, 2016 Accepting new patients

Locations

2512 Telegraph Ave
Berkeley, CA 94704
Phone (415) 509-5243

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JEHFAD/Endpoint/JEHFAD

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Bay View Rehabilitation Hospital LLCAlameda, CA, CCN 056348 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2024
Jan 1, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470182400000",
    "number": "1104846054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2512 TELEGRAPH AVE",
            "address_2": "STE 350",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947042918",
            "telephone_number": "415-420-4325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2512 TELEGRAPH AVE",
            "address_2": "STE 350",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947042918",
            "telephone_number": "415-420-4325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "ANTHONY",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2016-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A73148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.