Individual provider Active NPI

Dionisio A. Fernandes, MD

  • Allergy Physician
  • San Leandro, CA
National Provider Identifier
1285691121
Registry record updated Oct 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy PhysicianTaxonomy code 207KA0200X
License
A29416 Issued in CA
Practice address
13847 E 14TH St.
Ste 112
San Leandro, CA 94578
Phone
(510) 352-8585
Fax
(510) 352-8644
NPI assigned
Apr 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy Physician 207KA0200X A29416 CA Primary

Addresses

Primary practice location

13847 E 14TH St.
Ste 112
San Leandro, CA 94578

Mailing address

3448 Mowry Ave
Fremont, CA 94538-1422
Phone (510) 373-3000

Other identifiers 2

IdentifierTypeStateIssuer
GR0066330MedicaidCA
GR0066331MedicaidCA

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
I20090317000460 CA Practitioner - Allergy/ImmunologyPractitioner - Family PracticePractitioner - Pediatric Medicine 6800953936 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29416CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Baz Allergy, Asthma & Sinus Center Allergy CurrentSince Mar 31, 2016 Accepting new patients
The Davis Street Community Center Incorporated CurrentSince Jul 1, 2024 Accepting new patients
Baz Allergy, Asthma & Sinus Center, Inc. Allergy CurrentSince Mar 31, 2016 Accepting new patients
Baz Allergy, Asthma & Sinus Center, Inc. Allergy Current Accepting new patients
For Feet Sake Podiatry Group, Inc. PastSince Jun 11, 2015 Accepting new patients
Children'S Hospital & Research Center at Oakland Past Accepting new patients
Hayward Sisters Hospital Past Accepting new patients
Eden Medical Center/San Leandro Hospital Campus Past Accepting new patients
California Pacific Medical Group, Inc. Past Accepting new patients

Locations

1860 Mowry Ave
Ste 400
Fremont, CA 94538
Phone (510) 284-4100

7471 N Fresno St
Fresno, CA 93720
Phone (559) 436-4500

1560 W Lacey Blvd
Ste 103
Hanford, CA 93230
Phone (559) 582-8500

1415 Badger Flat Rd
Ste A
Los Banos, CA 93635
Phone (209) 710-8684

3081 Teagarden St
San Leandro, CA 94577
Phone (510) 347-4620

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9743/brand/1/csg/1/fhir/r4

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540425600000",
    "number": "1285691121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3448 MOWRY AVE",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381422",
            "telephone_number": "510-373-3000",
            "fax_number": "510-744-9959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13847 E 14TH ST.",
            "address_2": "STE 112",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "94578",
            "telephone_number": "510-352-8585",
            "fax_number": "510-352-8644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDES",
        "first_name": "DIONISIO",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2018-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "CA",
            "license": "A29416",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0066330",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0066331",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Leandro, CA

Sources for this page

Verify at the official NPI Registry.