Individual provider Active NPI

Nushrat Ullah, M.D.

  • Internal Medicine Physician
  • Novato, CA
National Provider Identifier
1205071222
Registry record updated Feb 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A120589 Issued in CA
Practice address
101 Rowland Way Ste 220
Novato, CA 94945-5056
Phone
(415) 878-7200
Fax
(415) 369-7916
NPI assigned
Dec 4, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 252800 NY
Internal Medicine Physician 207R00000X A120589 CA Primary

Addresses

Primary practice location

101 Rowland Way Ste 220
Novato, CA 94945-5056

Mailing address

2350 W El Camino Real FL 2
Mountain View, CA 94040-6203
Phone (415) 878-7200

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
I20120727000340 CA Practitioner - Internal Medicine 8729125679 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
New York Medical College, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marshall Medical CenterGroup PAC ID 7517875859, 168 clinicians

Practice addresses (Care Compare)

4201 Town Ctr Blvd
El Dorado Hills, CA 95762-7100
Phone (916) 905-6378

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A120589CAMDInternal Medicine Physician
252800NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North General Physician Services PLLC Internal Medicine PastSince Jul 1, 2006 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: nushrat.ullah.1@21842.direct.athenahealth.com

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 3

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": "1228348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551225600000",
    "number": "1205071222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 W EL CAMINO REAL FL 2",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940406203",
            "telephone_number": "415-878-7200",
            "fax_number": "415-369-7916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 ROWLAND WAY STE 220",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949455056",
            "telephone_number": "415-878-7200",
            "fax_number": "415-369-7916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULLAH",
        "first_name": "NUSHRAT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-04",
        "last_updated": "2019-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "252800",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A120589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Novato, CA

Sources for this page

Verify at the official NPI Registry.