NPIMap

Organization Active NPI

Sorenson & Sorenson MD Inc

  • Ophthalmology Physician
  • Berkeley, CA
National Provider Identifier
1215067749
Registry record updated Oct 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
07 00003652 Issued in CA
Legal business name
SORENSON & SORENSON MD INC
Practice address
3010 Colby St
Suite 114
Berkeley, CA 94705-2059
Phone
(510) 848-1413
Fax
(510) 848-7347
NPI assigned
Mar 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2016

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

Authorized official

Name
Dr. Robert Lynn Sorenson, M.D.NPI 1235220799
Title
Physician Owner
Phone
(510) 848-1413

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 07 00003652 CA Primary

Addresses

Primary practice location

3010 Colby St
Suite 114
Berkeley, CA 94705-2059

Mailing address

3010 Colby St
Suite 114
Berkeley, CA 94705-2059
Phone (510) 848-1413

Other identifiers 2

IdentifierTypeStateIssuer
GR0021950MedicaidCA
CP5491OtherCARAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050427000755 CA Part B Supplier - Clinic/Group Practice 2668411851 Receives reassigned benefits from 6 practitioners
Practice locations: Berkeley, CA
O20100930030956 CA DME Supplier - Physician - OphthalmologyDME Supplier - Physician - OptometristDME Supplier - Optician 2668411851 Practice locations: Berkeley, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Sorenson & Sorenson MD Inc3010 Colby St Ste 114, Berkeley, CA 94705-2059(510) 848-1413 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Apr 1, 1988

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475539200000",
    "number": "1215067749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3010 COLBY ST",
            "address_2": "SUITE 114",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052059",
            "telephone_number": "510-848-1413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3010 COLBY ST",
            "address_2": "SUITE 114",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052059",
            "telephone_number": "510-848-1413",
            "fax_number": "510-848-7347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SORENSON & SORENSON MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2016-10-04",
        "status": "A",
        "authorized_official_last_name": "SORENSON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "510-848-1413",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "07 00003652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0021950",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CP5491",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2016; 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.