Individual provider Active NPI

Nathaniel Peter Houston

  • Physician Assistant
  • Berkeley, CA
National Provider Identifier
1114705464
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA66396 Issued in CA
Practice address
837 Addison St
Berkeley, CA 94710-2047
Phone
(510) 981-4100
NPI assigned
Sep 18, 2023
Last updated
Nov 4, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

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 PA66396 CA Primary

Addresses

Primary practice location

837 Addison St
Berkeley, CA 94710-2047

Mailing address

1182 Walker Ave Unit 122
Walnut Creek, CA 94596-4971

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
I20251007000946 CA Practitioner - Physician Assistant 1355848441 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifelong Medical CareGroup PAC ID 2062304538, 75 clinicians

Practice addresses (Care Compare)

2031 6TH St
Berkeley, CA 94710-2006
Phone (510) 981-4200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
66396CAMDClinical Social Worker
PA66396CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lifelong Medical Care CurrentSince Aug 11, 2025 Accepting new patients
Lifelong Medical Care CurrentSince Aug 11, 2025 Accepting new patients
Lifelong Medical Care PastSince Aug 10, 2025 Accepting new patients

Locations

2344 6th St
Berkeley, CA 94710
Phone (510) 981-3203

10700 MacArthur Blvd
Ste 14B
Oakland, CA 94605
Phone (510) 563-4300

Organizations & group practices 3

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 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": "1694995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762214400000",
    "number": "1114705464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1182 WALKER AVE UNIT 122",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945964971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "837 ADDISON ST",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947102047",
            "telephone_number": "510-981-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUSTON",
        "first_name": "NATHANIEL",
        "middle_name": "PETER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-18",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA66396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.