Individual provider Active NPI

Elizabeth Vassallo-Deluca, M.D.

  • Internal Medicine Physician
  • Oakland, CA
National Provider Identifier
1134445885
Registry record updated Jan 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
125102 Issued in CA
Practice address
3801 Howe St
Kaiser Oakland- Internal Medicine
Oakland, CA 94611-5312
Phone
(510) 752-1190
NPI assigned
Apr 20, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2022

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 125102 CA Primary

Addresses

Primary practice location

3801 Howe St
Kaiser Oakland- Internal Medicine
Oakland, CA 94611-5312

Mailing address

3801 Howe St
Kaiser Oakland- Internal Medicine
Oakland, CA 94611-5312
Phone (510) 752-1190

Other names 1

  • Ms. Elizabeth Vassallo Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131112000149 CA Practitioner - Internal Medicine 6204062748 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

3801 Howe St
Oakland, CA 94611-5312
Phone (510) 752-1000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125102CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc Internal Medicine CurrentSince Oct 26, 2015 Accepting new patients
Permanente Medical Group, Inc CurrentSince Oct 26, 2015 Accepting new patients

Locations

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

3801 Howe St
Oakland, CA 94611
Phone (510) 752-1190

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

275 W MacArthur Blvd
Piedmont, CA 94611
Phone (510) 752-1375

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1271721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641772800000",
    "number": "1134445885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 HOWE ST",
            "address_2": "KAISER OAKLAND- INTERNAL MEDICINE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946115312",
            "telephone_number": "510-752-1190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 HOWE ST",
            "address_2": "KAISER OAKLAND- INTERNAL MEDICINE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946115312",
            "telephone_number": "510-752-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASSALLO-DELUCA",
        "first_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-20",
        "last_updated": "2022-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "125102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "275 W MacArthur Blvd",
            "city": "Oakland",
            "state": "CA",
            "country_code": "US",
            "postal_code": "946115641",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "VASSALLO",
            "prefix": "MS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.