Individual provider Active NPI

Pelen Tammy Wu, MD

  • Pediatrics Physician
  • Orinda, CA
National Provider Identifier
1194828707
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A75735 Issued in CA
Practice address
3 Altarinda Rd Ste 300
Orinda, CA 94563-2601
Phone
(925) 254-9500
Fax
(925) 254-9505
NPI assigned
Sep 7, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A75735 CA Primary

Addresses

Primary practice location

3 Altarinda Rd Ste 300
Orinda, CA 94563-2601

Mailing address

3 Altarinda Rd Ste 300
Orinda, CA 94563-2601
Phone (925) 254-9500

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
I20160825001591 CA Practitioner - Pediatric Medicine 1951696244 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A75735CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
John Muir Physician Network CurrentSince Jul 10, 2016 Accepting new patients
Children's Hospital & Research Center at Oakland Past Accepting new patients
Alta Bates Summit Medical Center Past Accepting new patients
Stanford Hospital and Clinics Past Accepting new patients
John Muir Health Past Accepting new patients

Locations

2400 Balfour Rd
Ste 120
Brentwood, CA 94513
Phone (925) 308-8112

3 Altarinda Rd
Ste 300
Orinda, CA 94563
Phone (925) 254-9500

1450 Treat Blvd
Ste 300
Walnut Creek, CA 94597

Interoperability endpoints

  • Direct secure messaging: pwu12476@ehr.johnmuirhealth.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1194828707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 ALTARINDA RD STE 300",
            "city": "ORINDA",
            "state": "CA",
            "postal_code": "945632601",
            "telephone_number": "925-254-9500",
            "fax_number": "925-254-9505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 ALTARINDA RD STE 300",
            "city": "ORINDA",
            "state": "CA",
            "postal_code": "945632601",
            "telephone_number": "925-254-9500",
            "fax_number": "925-254-9505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WU",
        "first_name": "PELEN",
        "middle_name": "TAMMY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-07",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A75735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orinda, CA

Sources for this page

Verify at the official NPI Registry.