Organization Active NPI

Nor Cal Urology Medical Group Inc

  • Urology Physician
  • Oakland, CA
National Provider Identifier
1275547127
Registry record updated Nov 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
NOR CAL UROLOGY MEDICAL GROUP INC
Practice address
3300 Webster St Ste 710
Oakland, CA 94609-3122
Phone
(510) 465-5800
Fax
(510) 267-1833
NPI assigned
Jul 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2025

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

Authorized official

Name
Brandon Boots
Title
Practice Administrator
Phone
(510) 213-2261

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X
Urology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208800000X CA Primary

Addresses

Primary practice location

3300 Webster St Ste 710
Oakland, CA 94609-3122

Mailing address

3300 Webster St Ste 710
Oakland, CA 94609-3122
Phone (510) 465-5800

Other identifiers 1

IdentifierTypeStateIssuer
GR0071770MedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other eSolutions Inc.

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190907000305 CA DME Supplier - Physician - Urology 4284696956 Practice locations: Oakland, CA

National Provider Directory

National Provider Directory

Locations

20101 Lake Chabot Rd
#A
Castro Valley, CA 94546
Phone (415) 581-5330

2700 Grant St
Ste 316
Concord, CA 94520
Phone (925) 338-8511

5201 Norris Canyon Rd
Ste 21
San Ramon, CA 94583
Phone (925) 866-2100

355 Lennon Ln
Ste 205
Walnut Creek, CA 94598
Phone (925) 935-0627

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764115200000",
    "number": "1275547127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 WEBSTER ST STE 710",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093122",
            "telephone_number": "510-465-5800",
            "fax_number": "510-267-1833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 WEBSTER ST STE 710",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093122",
            "telephone_number": "510-465-5800",
            "fax_number": "510-267-1833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOR CAL UROLOGY MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-28",
        "last_updated": "2025-11-26",
        "certification_date": "2025-11-26",
        "status": "A",
        "authorized_official_last_name": "BOOTS",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "510-213-2261"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0071770",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc.",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Nov 26, 2025; 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.