Individual provider Active NPI

Dianna L Lange, NP

  • Nurse Practitioner
  • Emeryville, CA
National Provider Identifier
1245666981
Registry record updated Apr 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
23653 Issued in CA
Practice address
2100 Powell Street
Suite 900
Emeryville, CA 94608
Phone
(510) 350-2600
NPI assigned
Sep 25, 2013
Last updated
Apr 2, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 23653 CA Primary

Addresses

Primary practice location

2100 Powell Street
Suite 900
Emeryville, CA 94608

Mailing address

2100 Powell St
Emeryville, CA 94608-1826
Phone (510) 350-2600

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140118000406 CA Practitioner - Nurse Practitioner 0244468262 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - CaliforniaGroup PAC ID 6103739131, 1,278 clinicians
Cottage Clinical Network LLCGroup PAC ID 1850712530, 57 clinicians

Practice addresses (Care Compare)

1600 N Rose Ave
Oxnard, CA 93030-3722
Phone (805) 988-2500

5652 Calle Real
Goleta, CA 93117-2317
Phone (805) 879-4239

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
23653CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California CurrentSince Jun 1, 2018 Accepting new patients
Cep America - California Current Accepting new patients
Cottage Clinical Network, LLC CurrentSince Jun 1, 2021 Accepting new patients
Cottage Medical Associates Past Accepting new patients

Locations

328 McMurray Rd
Ste 102
Buellton, CA 93427
Phone (805) 688-2600

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

7070 Hollister Ave
Ste 103
Goleta, CA 93117
Phone (805) 324-9270

7070 Hollister Ave
Ste C23
Goleta, CA 93117

24451 Health Center Dr
Laguna Hills, CA 92653
Phone (949) 452-3573

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

1606 E Clark Ave
#102
Orcutt, CA 93455

1600 N Rose Ave
Oxnard, CA 93030
Phone (805) 988-2500

15031 Rinaldi St
San Fernando, CA 91345
Phone (818) 365-8051

3970 Broad St
Ste 2
San Luis Obispo, CA 93401
Phone (805) 762-4996

777 E Foothill Blvd
San Luis Obispo, CA 93405
Phone (805) 762-4348

1298 Coast Village Rd
Santa Barbara, CA 93108
Phone (805) 565-1565

3885 State St
Ste A
Santa Barbara, CA 93105
Phone (805) 569-7351

5652 Calle Real
Santa Barbara, CA 93117
Phone (805) 641-6033

1846 N Broadway
#A
Santa Maria, CA 93454
Phone (805) 361-4279

3596 Skyway Dr
Ste A
Santa Maria, CA 93455

1708 S Victoria Ave
Ste D
Ventura, CA 93003
Phone (805) 290-4985

Organizations & group practices 5

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 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": "1380067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585785600000",
    "number": "1245666981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 POWELL ST",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081826",
            "telephone_number": "510-350-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 POWELL STREET",
            "address_2": "SUITE 900",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "94608",
            "telephone_number": "510-350-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGE",
        "first_name": "DIANNA",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-25",
        "last_updated": "2020-04-02",
        "certification_date": "2020-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "23653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Emeryville, CA

Sources for this page

Verify at the official NPI Registry.