Active NPI
Alameda Health System
- Orthopaedic Surgery Physician
- Oakland, CA
National Provider Identifier
1205988490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- Legal business name
- ALAMEDA HEALTH SYSTEM
- Practice address
- 1411 E 31St St
Oakland, CA 94602-1018 - Phone
- (510) 437-4800
- Fax
- (510) 437-4187
- NPI assigned
- Jan 17, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Bernadette Jensen
- Title
- VP of Revenue Cycle
- Phone
- (510) 618-2147
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | Primary |
Addresses
Primary practice location
1411 E 31St St
Oakland, CA 94602-1018
Mailing address
15400 Foothill Blvd
San Leandro, CA 94578-1009
Phone (510) 895-7344
Other names 1
- ORTHOPEDIC DEPT
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031110000764 | CA | Part B Supplier - Clinic/Group Practice | 3779494521 |
Receives reassigned benefits from 973 practitioners 11 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Alameda, CA; Castro Valley, CA; Hayward, CA; Newark, CA; Oakland, CA; San Leandro, CA |
Other NPIs on the same Medicare enrollment 11
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Federally Qualified Health Center (FQHC)
- Hayward, CA
- NPI 1023219821
O20031110000764
-
- Federally Qualified Health Center (FQHC)
- Newark, CA
- NPI 1497956288
O20031110000764
-
- Federally Qualified Health Center (FQHC)
- San Leandro, CA
- NPI 1558749440
O20031110000764
-
- Federally Qualified Health Center (FQHC)
- Oakland, CA
- NPI 1932300738
O20031110000764
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168992000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1464307200000",
"number": "1205988490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15400 FOOTHILL BLVD",
"city": "SAN LEANDRO",
"state": "CA",
"postal_code": "945781009",
"telephone_number": "510-895-7344",
"fax_number": "510-895-7229"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1411 E 31ST ST",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946021018",
"telephone_number": "510-437-4800",
"fax_number": "510-437-4187"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ALAMEDA HEALTH SYSTEM",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-17",
"last_updated": "2016-05-27",
"status": "A",
"authorized_official_last_name": "JENSEN",
"authorized_official_first_name": "BERNADETTE",
"authorized_official_title_or_position": "VP OF REVENUE CYCLE",
"authorized_official_telephone_number": "510-618-2147"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Orthopaedic Surgery",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "ORTHOPEDIC DEPT",
"code": "5",
"type": "Other Name"
}
]
}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 May 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.