Individual provider Active NPI

Angela Qi

  • Speech-Language Pathologist
  • Oakland, CA
National Provider Identifier
1134958697
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
19492 Issued in CA
Practice address
2780 26TH Ave
Oakland, CA 94601-1911
Phone
(510) 536-1838
NPI assigned
Jul 31, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 19492 CA Primary

Addresses

Primary practice location

2780 26TH Ave
Oakland, CA 94601-1911

Mailing address

PO Box 6002
Albany, CA 94706-0002

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260225000162 TN Practitioner - Qualified Speech Language Pathologist 1052892304 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Powerback Rehabilitation LLCGroup PAC ID 2365359932, 600 clinicians

Practice addresses (Care Compare)

8234 Hwy 100
Nashville, TN 37221-4043
Phone (615) 490-8047

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9310TNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Powerback Rehabilitation LLC Speech-Language Pathologist CurrentSince Jan 13, 2026 Accepting new patients
Powerback Rehabilitation LLC Speech-Language Pathologist CurrentSince Jan 13, 2026 Accepting new patients

Locations

101 E State St
Kennett Square, PA 19348
Phone (610) 925-4436

8234 Highway 100
Nashville, TN 37221
Phone (615) 490-8047

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": "1722384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1134958697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6002",
            "city": "ALBANY",
            "state": "CA",
            "postal_code": "947060002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2780 26TH AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946011911",
            "telephone_number": "510-536-1838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QI",
        "first_name": "ANGELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-31",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "19492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.