Oliver K Khakmahd, MD
Individual provider Active NPI Nephrology Physician · Berkeley, CA
NPI 1164529830 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1164529830
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nephrology Physician 207RN0300X
- License
- A48805 (CA)
- Practice address
- 2905 Telegraph Ave
Berkeley, CA 94705-2063 - Phone
- (510) 841-0411
- Fax
- (510) 845-5030
- NPI assigned
- Sep 17, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 11
Hospital & facility affiliations 11
Medicare Care Compare profile
- Specialty
- Nephrology
- Education
- Other, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- East Bay Nephrology Medical Group Inc
Dialysis Access Center a Medical Corporation
Practice addresses (Care Compare)
2089 Vale Rd
Suite 32
San Pablo, CA 94806-3850
Phone (510) 235-1057
2905 Telegraph Ave
Berkeley, CA 94705-2017
Phone (510) 841-0411
3012 Summit St
Oakland, CA 94609-3480
Phone (510) 251-1002
350 30TH St
Suite 311
Oakland, CA 94609-3425
Phone (510) 625-8310
Hospital & facility affiliations
- Rai-Oakland Home Program
- DaVita Oakland Peritoneal Dialysis Center
- Alta Bates Summit Medical Center
- Alta Bates Summit Medical Center - Alta Bates Camp
- Stanford Health Care
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080624000217 | CA | Practitioner - Nephrology |
6204843303 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A48805 | CA | MD | Nephrology Physician |
Practice roles (10 of 11)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| East Bay Nephrology Medical Group, Inc. | Nephrology | Current |
Accepting new patients |
| Dialysis Access Center a Medical Corporation | Nephrology | Current |
Accepting new patients |
| East Bay Nephrology Medical Group, Inc. | Nephrology | Current | Accepting new patients |
| Alta Bates Summit Medical Center | Past | Accepting new patients | |
| Regents of the Univ of Ca | Past | Accepting new patients | |
| Sutter Bay Hospitals | Past | Accepting new patients | |
| California Pacific Medical Group, Inc. | Past | Accepting new patients | |
| Hill Physicians Medical Group - PPO Program | Past | Accepting new patients | |
| Sutter Valley Hospitals | Past | Accepting new patients | |
| Alameda Health System | Past | Accepting new patients |
Locations
2905 Telegraph Ave
Berkeley, CA 94705
Phone (510) 841-0411
10690 San Pablo Ave
El Cerrito, CA 94530
Phone (510) 528-9590
3012 Summit St
Fl D
Oakland, CA 94609
3012 Summit St
Oakland, CA 94609
Phone (510) 251-1002
350 30th St
Ste 311
Oakland, CA 94609
Phone (510) 465-0941
3043 Summit St
Oakland, CA 94609
Phone (510) 451-6840
1411 E 31st St
Oakland, CA 94602
Phone (510) 437-4323
3012 Summit St
#D
Oakland, CA 94609
Phone (510) 251-1002
14020 San Pablo Ave
Ste A
San Pablo, CA 94806
Phone (510) 235-1057
2089 Vale Rd
Ste 32
San Pablo, CA 94806
Phone (510) 232-0892
125 Hospital Dr
Vallejo, CA 94589
Phone (707) 642-7510
127 Hospital Dr
Ste 204
Vallejo, CA 94589
Phone (707) 642-7510
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- okhakmahd14280@alamedahs.direct-ci.com
- oliver.khakmahd.1@6134.direct.athenahealth.com
- oliver.khakmahd.d1.p72@direct.aac.nextgenshare.com
- okhakmahd135671@hisp.ehr.sutterhealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | A48805 | CA | Yes |
Addresses
Primary practice location
2905 Telegraph Ave
Berkeley, CA 94705-2063
Mailing address
2905 Telegraph Ave
Berkeley, CA 94705-2063
Phone (510) 841-0411
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 390003258 | Other | CA | RAILROAD MEDICARE |
| 00A488050 | Medicaid | CA |
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All providers in Berkeley, CA · Nephrology Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.