NPIMap

Individual provider Active NPI

Soma Mandal, MD

  • Internal Medicine Physician
  • Hayward, CA
National Provider Identifier
1255419008
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A85773 Issued in CA
Practice address
27400 Hesperian Blvd
Hayward, CA 94545-4235
Phone
(510) 784-4000
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A85773 CA Primary

Addresses

Primary practice location

27400 Hesperian Blvd
Hayward, CA 94545-4235

Mailing address

1800 Harrison St FL 7
Oakland, CA 94612-3429
Phone (510) 625-6262

Other identifiers 1

IdentifierTypeStateIssuer
00A857730MedicaidCA

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
I20041210000868 CA Practitioner - Internal Medicine 4082671094 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of San MateoGroup PAC ID 9032023171, shared by 15 NPIs, 316 clinicians

Practice addresses (Care Compare)

222 W 39TH Ave
San Mateo, CA 94403-4364
Phone (650) 573-2222

Hospital & facility affiliations

  • San Mateo Medical Center Hospital, San Mateo, CA, CCN 050113
  • Peninsula Medical Center Hospital, Burlingame, CA, CCN 050007

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
85773CAMDPharmacist
A85773CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Mateo CurrentSince Jul 1, 2011 Accepting new patients
County of San Mateo CurrentSince Jan 1, 2007 Accepting new patients
County of San Mateo CurrentSince Jan 1, 2007 Accepting new patients

Locations

222 W 39th Ave
San Mateo, CA 94403
Phone (415) 573-2222

Interoperability endpoints

  • Direct secure messaging: smandal19856@smch.direct-ci.com

Organizations & group practices 3

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 10

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255419008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 HARRISON ST FL 7",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946123429",
            "telephone_number": "510-625-6262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27400 HESPERIAN BLVD",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945454235",
            "telephone_number": "510-784-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDAL",
        "first_name": "SOMA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A85773",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A857730",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hayward, CA

Sources for this page

Verify at the official NPI Registry.