Amin Shabbir Azam, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

118708 Issued in CA

Practice address

3600 Broadway
Oakland, CA 94611-5730

Phone

(510) 752-1000

NPI assigned

Oct 31, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations (25 of 39)

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IBCJAA

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.

• Sedaze Anesthesia Consultants a Professional Nursing Corporation

  • Certified Registered Nurse Anesthetist
  • Castro Valley, CA
  • NPI 1366209629

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD Authorized official
• Amsurg Oakland Anesthesia LP

  • Anesthesiology Physician
  • Oakland, CA
  • NPI 1679847727
  Medicare reassignment NPD
• Digestive Health Associates of Southern California

  • Certified Registered Nurse Anesthetist
  • Santa Monica, CA
  • NPI 1639604747

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Mai Nursing Anesthesia PC

  • Anesthesiology Physician
  • San Francisco, CA
  • NPI 1003572769
  Medicare reassignment NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299
  Medicare reassignment NPD
• Premier Anesthesia of California, PC

  • Anesthesiology Physician
  • San Ramon, CA
  • NPI 1770691859

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Santa Rosa Surgical Services LLC

  • Ambulatory Surgical Clinic/Center
  • Santa Rosa, CA
  • NPI 1497407894
  Medicare reassignment NPD
• SCQ Anesthesia a Professional Nursing Corporation

  • Certified Registered Nurse Anesthetist
  • Tarzana, CA
  • NPI 1689381105

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Valley Regional Anesthesia Associates Inc

  • Anesthesiology Physician
  • Fresno, CA
  • NPI 1578272415
  Medicare reassignment NPD
• Vallot Nurse Anesthesia, a Professional Corporation

  • Certified Registered Nurse Anesthetist
  • Sacramento, CA
  • NPI 1811386246
  Medicare reassignment
• Digestive Health Associates of Southern California

  • Anatomic Pathology & Clinical Pathology Physician
  • Santa Monica, CA
  • NPI 1043098619
  NPD
• Pacific Vascular Access Care, Inc

  • Vascular & Interventional Radiology Physician
  • Downey, CA
  • NPI 1629846670

  Nurse Anesthetist, Certified Registered

  NPD

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

{
    "created_epoch": "1540944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1255808929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 BROADWAY",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946115730",
            "telephone_number": "510-239-3432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 BROADWAY",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946115730",
            "telephone_number": "510-752-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZAM",
        "first_name": "AMIN",
        "middle_name": "SHABBIR",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-31",
        "last_updated": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "118708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "275 W. Macarthur Blvd",
            "city": "Oakland",
            "state": "CA",
            "country_code": "US",
            "postal_code": "94611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lilliannia Renee Ayers
• Annet Ayesigye
• Melissa Beth Theresa Ayres, MPH, RDN
• Awista Ayuby, MD
• Cibelle Azadui
• Jennifer Dawn Pearce Azam, LCSW
• Janice M. Azebu, DO
• Nicholas Azevedo
• Ajay Mani Raj Azhagarasan
• Anna Elizabeth Azimi, MSW

• Certified Registered Nurse Anesthetist in Oakland, CA
• Providers in Oakland, CA by specialty
• Certified Registered Nurse Anesthetist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2022; 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.