Annie Joan Delisle, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A117786 Issued in CA

Practice address

2001 Dwight Way
Inside Alta Bates / Herrick
Berkeley, CA 94704-2608

Phone

(510) 981-4100

NPI assigned

Sep 16, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1316131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356566400000",
    "number": "1295017093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2344 6TH STREET",
            "address_2": "ATTENTION: CREDENTIALING DEPT.",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "94710",
            "telephone_number": "510-981-4100",
            "fax_number": "510-553-2169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 DWIGHT WAY",
            "address_2": "INSIDE ALTA BATES / HERRICK",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947042608",
            "telephone_number": "510-981-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELISLE",
        "first_name": "ANNIE",
        "middle_name": "JOAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-16",
        "last_updated": "2012-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A117786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alicia Del Prado, PH.D.
• Geri Ann Delarosa, PHD
• Stephanie Deleon-Valencia
• Marisol Delgado Munoz, RN
• Zachary Deligiannis
• Hannah Christine Dellacroce, BA
• Celenia Delsol, M.A., J.D.
• Abigail Dembo
• Brittany Michele Demont, NP
• Deborah Lynn Demott, M.D.

• Family Medicine Physician in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2012; 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.

Verify at the official NPI Registry.