NPIMap

Individual provider Active NPI

Marjorie M Macqueen, PA

  • Emergency Medicine Physician
  • Berkeley, CA
National Provider Identifier
1215995576
Registry record updated Apr 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
PA17161 Issued in CA
Practice address
2450 Ashby Avenue
Berkeley, CA 94705-2067
Phone
(510) 204-4444
NPI assigned
May 3, 2006
Last updated
Apr 15, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X PA17161 CA Primary

Addresses

Primary practice location

2450 Ashby Avenue
Berkeley, CA 94705-2067

Mailing address

PO Box 12469
Westminster, CA 92685-2469
Phone (866) 325-0282

Other identifiers 2

IdentifierTypeStateIssuer
PA17161MedicaidCA
1215995576MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040422001222 CA Practitioner - Physician Assistant 4981690161 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alameda Health SystemGroup PAC ID 3779494521, 597 clinicians

Practice addresses (Care Compare)

1411 E 31St St
Oakland, CA 94602-1018
Phone (510) 437-4800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.17 of 100Reported as group
Quality
86.93
Promoting interoperability
100
Improvement activities
40
Cost
72.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of California San Francisco CurrentSince Sep 1, 2007 Accepting new patients
Alameda Health System CurrentSince Mar 12, 2015 Accepting new patients
Alameda Health System CurrentSince Mar 12, 2015 Accepting new patients
Regents of the University of California CurrentSince Sep 1, 2007 Accepting new patients
Berkeley Emergency Medical Group, Inc. Emergency Medicine CurrentSince Dec 1, 2003 Accepting new patients
Berkeley Emergency Medical Group, Inc. Emergency Medicine PastSince Jan 22, 2023 Accepting new patients

Locations

2450 Ashby Ave
Berkeley, CA 94705
Phone (510) 204-1566

1411 E 31st St
Oakland, CA 94602
Phone (510) 437-4323

350 Hawthorne Ave
Oakland, CA 94609
Phone (510) 655-4000

7677 Oakport St
Ste 1200
Oakland, CA 94621
Phone (510) 618-5768

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

Interoperability endpoints

  • Direct secure messaging: mmacqueen11969@alamedahs.direct-ci.com

Organizations & group practices 7

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": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239753600000",
    "number": "1215995576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12469",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926852469",
            "telephone_number": "866-325-0282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 ASHBY AVENUE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052067",
            "telephone_number": "510-204-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACQUEEN",
        "first_name": "MARJORIE",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-03",
        "last_updated": "2009-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "PA17161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA17161",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1215995576",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.