Individual provider Active NPI

Penna Kim Bui, M.D.

  • Anesthesiology Physician
  • Castro Valley, CA
National Provider Identifier
1225045149
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A81774 Issued in CA
Practice address
20103 Lake Chabot Rd
Castro Valley, CA 94546-5305
Phone
(510) 870-2497
Fax
(562) 933-1245
NPI assigned
Aug 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X A81774 CA Primary

Addresses

Primary practice location

20103 Lake Chabot Rd
Castro Valley, CA 94546-5305

Mailing address

PO Box 10429
Newport Beach, CA 92658-0429
Phone (949) 417-1812

Other identifiers 3

IdentifierTypeStateIssuer
00A817740OtherCABLUE SHIELD ID #
00A817740385OtherCACALOPTIMA ID #
00A817740MedicaidCA

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
I20050819000656 CA Practitioner - Anesthesiology 3072543941 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Texas Medical School at San Antonio, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alameda Anesthesia Associates Medical Group IncGroup PAC ID 4688642028, 20 clinicians

Practice addresses (Care Compare)

20103 Lake Chabot Rd
Castro Valley, CA 94546-5305
Phone (510) 537-1234

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
81774CAMDPharmacist
A81774CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alameda Anesthesia Associates Medical Group, Inc Anesthesiology CurrentSince Nov 27, 2006 Accepting new patients
California Anesthesia Associates Medical Group, Inc. Anesthesiology Past Accepting new patients

Locations

20998 Redwood Rd
Castro Valley, CA 94546
Phone (510) 538-2828

20103 Lake Chabot Rd
Hayward, CA 94546
Phone (510) 537-1234

Interoperability endpoints

  • Direct secure messaging: pbui141804@hisp.ehr.sutterhealth.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1225045149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10429",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926580429",
            "telephone_number": "949-417-1812",
            "fax_number": "949-417-1803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20103 LAKE CHABOT RD",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945465305",
            "telephone_number": "510-870-2497",
            "fax_number": "562-933-1245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUI",
        "first_name": "PENNA",
        "middle_name": "KIM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-02",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A81774",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD ID #",
            "identifier": "00A817740",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALOPTIMA ID #",
            "identifier": "00A817740385",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A817740",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Castro Valley, CA

Sources for this page

Verify at the official NPI Registry.