Individual provider Active NPI

Eugene L Schoenfeld, MD

  • Psychiatry Physician
  • San Rafael, CA
National Provider Identifier
1255634747
Registry record updated Apr 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
C24333 Issued in CA
Practice address
1368 Lincoln Ave Ste 207
San Rafael, CA 94901-2121
Phone
(415) 331-6832
Fax
(415) 331-9513
NPI assigned
Dec 6, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X C24333 CA
Psychiatry Physician 2084P0800X C24333 CA Primary

Addresses

Primary practice location

1368 Lincoln Ave Ste 207
San Rafael, CA 94901-2121

Mailing address

1368 Lincoln Ave Ste 207
San Rafael, CA 94901-2121
Phone (415) 331-6832

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
I20170523000972 CA Practitioner - PsychiatryPractitioner - Addiction Medicine 3870896806 Practice locations: San Rafael, CA

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Addiction Medicine
Education
University of Utah School of Medicine, 1961
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1368 Lincoln Ave
Suite 207
San Rafael, CA 94901-2121
Phone (415) 331-6832

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C24333CAMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1291593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524528000000",
    "number": "1255634747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1368 LINCOLN AVE STE 207",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012121",
            "telephone_number": "415-331-6832",
            "fax_number": "415-331-9513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1368 LINCOLN AVE STE 207",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012121",
            "telephone_number": "415-331-6832",
            "fax_number": "415-331-9513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHOENFELD",
        "first_name": "EUGENE",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-12-06",
        "last_updated": "2018-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "CA",
            "license": "C24333",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "C24333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

Verify at the official NPI Registry.