Individual provider Active NPI

Linda Ruth Clem, PA

  • Physician Assistant
  • Greenbrae, CA
National Provider Identifier
1104899772
Registry record updated Nov 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA 16747 Issued in CA
Practice address
1350 S Eliseo Dr
Greenbrae, CA 94904-2011
Phone
(415) 925-3590
NPI assigned
Feb 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA 16747 CA Primary

Addresses

Primary practice location

1350 S Eliseo Dr
Greenbrae, CA 94904-2011

Mailing address

507 Bridge View CT
Point Richmond, CA 94801-4128
Phone (510) 412-0145

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041208001178 CA Practitioner - Physician Assistant 0941266191 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Urgent Care Plus Telehealth IncGroup PAC ID 0941630123, 27 clinicians

Practice addresses (Care Compare)

1387 E 2ND St
Benicia, CA 94510-2836
Phone (707) 377-1005

440 E Washington St
Suite D
Petaluma, CA 94952-5923
Phone (707) 940-5005

446 W Napa St
Sonoma, CA 95476-6519
Phone (707) 690-5332

Hospital & facility affiliations

  • Sonoma Valley Hospital Hospital, Sonoma, CA, CCN 050090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
16747CAMDAcupuncturist
PA 16747CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent Care Plus Telehealth Inc CurrentSince May 22, 2023 Accepting new patients
California Em-I Medical Services Physician Assistant Past Accepting new patients
Urgent Care Plus Telehealth Inc PastSince Dec 13, 2022 Accepting new patients

Locations

1387 E 2nd St
Benicia, CA 94510
Phone (707) 377-1005

446 W Napa St
Sonoma, CA 95476
Phone (707) 690-5332

Interoperability endpoints

  • Direct secure messaging: linda.clem.1@25843.direct.athenahealth.com
  • Direct secure messaging: linda.clem.1@21754.direct.athenahealth.com

Organizations & group practices 4

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 1

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": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226534400000",
    "number": "1104899772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 BRIDGE VIEW CT",
            "city": "POINT RICHMOND",
            "state": "CA",
            "postal_code": "948014128",
            "telephone_number": "510-412-0145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 S ELISEO DR",
            "city": "GREENBRAE",
            "state": "CA",
            "postal_code": "949042011",
            "telephone_number": "415-925-3590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEM",
        "first_name": "LINDA",
        "middle_name": "RUTH",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-13",
        "last_updated": "2008-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA 16747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenbrae, CA

Sources for this page

Verify at the official NPI Registry.