NPIMap

Organization Active NPI

Douglas J Abeles, MD, Inc.

  • Specialist
  • Castro Valley, CA
National Provider Identifier
1255530077
Registry record updated Jan 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G079953 Issued in CA
Legal business name
DOUGLAS J ABELES, MD, INC.
Practice address
21030 Redwood Road
Castro Valley, CA 94546-5920
Phone
(510) 538-0430
Fax
(510) 538-1839
NPI assigned
Jul 12, 2007
Last updated
Jan 29, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2015

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

Authorized official

Name
Dr. Douglas AbelesNPI 1508961582
Title
Owner
Phone
(510) 538-0430

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X G079953 CA Primary

Addresses

Primary practice location

21030 Redwood Road
Castro Valley, CA 94546-5920

Mailing address

21030 Redwood Rd
Castro Valley, CA 94546-5920
Phone (510) 538-0430

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071108000233 CA Part B Supplier - Clinic/Group Practice 1456449453 Receives reassigned benefits from 7 practitioners
Practice locations: Castro Valley, CA

National Provider Directory

National Provider Directory

Locations

21030 Redwood Rd
Castro Valley, CA 94546
Phone (510) 538-0430

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422489600000",
    "number": "1255530077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21030 REDWOOD RD",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945465920",
            "telephone_number": "510-538-0430",
            "fax_number": "510-538-1839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21030 REDWOOD ROAD",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945465920",
            "telephone_number": "510-538-0430",
            "fax_number": "510-538-1839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLAS J ABELES, MD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-12",
        "last_updated": "2015-01-29",
        "status": "A",
        "authorized_official_last_name": "ABELES",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "510-538-0430",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G079953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Castro Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.