Active NPI
Hannah Ethel Barbara Boal, MD
- Pediatrics Physician
- Oakland, CA
National Provider Identifier
1265675243
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- A119650
- Practice address
- 3100 Telegraph Ave
Suite 2103
Oakland, CA 94609-3239 - Phone
- (510) 452-5231
- NPI assigned
- Apr 7, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | A119650 | CA | Primary |
Addresses
Primary practice location
3100 Telegraph Ave
Suite 2103
Oakland, CA 94609-3239
Mailing address
3100 Telegraph Ave
Suite 2103
Oakland, CA 94609-3239
Phone (510) 452-5231
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A119650 | CA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| LPCH Medical Group Div of Lucile | Pediatrics | Current | Accepting new patients |
| Bayside Medical Group, Inc | Pediatrics | Past | Accepting new patients |
Locations
2915 Telegraph Ave
Ste 200
Berkeley, CA 94705
Phone (510) 647-0893
3100 Telegraph Ave
Ste 2103
Oakland, CA 94609
Phone (510) 452-5231
725 Welch Rd
Palo Alto, CA 94304
Phone (650) 497-8979
Interoperability endpoints
- hboal177793@hisp.ehr.sutterhealth.org
Organizations & group practices 2
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.
-
- Pediatrics Physician
- Pleasanton, CA
- NPI 1689633240
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1239062400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1388102400000",
"number": "1265675243",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3100 TELEGRAPH AVE",
"address_2": "SUITE 2103",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946093239",
"telephone_number": "510-452-5231"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 TELEGRAPH AVE",
"address_2": "SUITE 2103",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946093239",
"telephone_number": "510-452-5231"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOAL",
"first_name": "HANNAH",
"middle_name": "ETHEL BARBARA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-04-07",
"last_updated": "2013-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "A119650",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.