Avis Etta Logan, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G73867 Issued in CA

Practice address

3100 San Pablo Ave # 310
Berkeley, CA 94702

Phone

(510) 985-5020

NPI assigned

Feb 9, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Family Practice

Education

University of California, Davis School of Medicine, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

John Muir Physician NetworkGroup PAC ID 6608789813, 488 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Alta Bates Summit Medical Center Hospital, Oakland, CA, CCN 050043
• Alta Bates Summit Medical Center - Alta Bates Camp Hospital, Berkeley, CA, CCN 050305
• John Muir Medical Center - Walnut Creek Campus Hospital, Walnut Creek, CA, CCN 050180
• Stanford Health Care Hospital, Stanford, CA, CCN 050441
• UCSF Medical Center Hospital, San Francisco, CA, CCN 050454

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: alogan119109@ehr.johnmuirhealth.com

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.

• John Muir Physician Network

  • General Practice Physician
  • Walnut Creek, CA
  • NPI 1841407665
  Medicare reassignment Care Compare group NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299

  Family Medicine

  Medicare reassignment NPD
• North Oakland Family Practice

  • Family Medicine Physician
  • Oakland, CA
  • NPI 1508908377
  NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Stockton, CA
  • NPI 1548343510

  Family Medicine

  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD
• Alta Bates Summit Medical Center

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Oakland, CA
  • NPI 1043358542
  NPD (past)
• John Muir Health

  • Rehabilitation Hospital Unit
  • Walnut Creek, CA
  • NPI 1447269303
  NPD (past)
• John Muir Health

  • General Acute Care Hospital
  • Concord, CA
  • NPI 1801821376
  NPD (past)
• Sutter Bay Hospitals

  • Rehabilitation Hospital Unit
  • Oakland, CA
  • NPI 1194171371
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• John Muir Health

  • General Acute Care Hospital
  • Walnut Creek, CA
  • NPI 1740215219
  Care Compare affiliation
• Stanford Health Care

  • Radiation Oncology Physician
  • Pleasanton, CA
  • NPI 1124561758

  Hospital

  Care Compare affiliation
• Stanford Health Care

  • General Acute Care Hospital
  • Emeryville, CA
  • NPI 1275076325
  Care Compare affiliation
• Stanford Health Care

  • General Acute Care Hospital
  • Emeryville, CA
  • NPI 1285177337
  Care Compare affiliation
• Stanford Health Care

  • General Acute Care Hospital
  • Stanford, CA
  • NPI 1437292927
  Care Compare affiliation
• Stanford Health Care

  • General Acute Care Hospital
  • Pleasanton, CA
  • NPI 1467990465
  Care Compare affiliation
• Stanford Health Care

  • General Acute Care Hospital
  • Stanford, CA
  • NPI 1871543215
  Care Compare affiliation
• Stanford Life Flight

  • Air Ambulance
  • Stanford, CA
  • NPI 1114063203

  Hospital

  Care Compare affiliation
• Sutter Bay Hospitals

  • General Acute Care Hospital
  • Oakland, CA
  • NPI 1295181477
  Care Compare affiliation
• Sutter Bay Hospitals

  • General Acute Care Hospital
  • Berkeley, CA
  • NPI 1639523004
  Care Compare affiliation
• University of California, San Francisco

  • General Acute Care Hospital
  • San Francisco, CA
  • NPI 1689772592
  Care Compare affiliation

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530489600000",
    "number": "1235102252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 TREAT BLVD # 300",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945972168",
            "telephone_number": "925-952-2888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 SAN PABLO AVE # 310",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "94702",
            "telephone_number": "510-985-5020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "AVIS",
        "middle_name": "ETTA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-09",
        "last_updated": "2018-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G73867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ16371Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0028630",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiffany Nicole Lockett
• Sybil Lockhart, LMFT
• Pia Lodberg, DDS
• Elana Yosefa Loeb
• Lisa Loewy
• Deanna May Loh, AMFT
• Beate Maria Lohser
• Katja Rydale Lohser
• Matthew Panaligan Lojo, RN
• Patricia R. Lollis, L.AC.

• Family Medicine Physician in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.