Bay Area Rehabilitation Medical Group

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

G192980 Issued in CA

Legal business name

BAY AREA REHABILITATION MEDICAL GROUP

Practice address

2001 Dwight Way
Berkeley, CA 94704-2608

Phone

(510) 204-4411

NPI assigned

May 27, 2005

Last updated

May 14, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Herbert Goodman, M.D.

Title

Partner

Phone

(510) 204-4411

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210723200000",
    "number": "1295738805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 HAYES ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941171013",
            "telephone_number": "415-750-5761",
            "fax_number": "415-666-0210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 DWIGHT WAY",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947042608",
            "telephone_number": "510-204-4411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAY AREA REHABILITATION MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-27",
        "last_updated": "2008-05-14",
        "status": "A",
        "authorized_official_last_name": "GOODMAN",
        "authorized_official_first_name": "HERBERT",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "510-204-4411",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "G192980",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MCRERR",
            "identifier": "CP1128",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0008972",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Bay Imaging Consultants Medical Group, Inc.

• Physical Medicine & Rehabilitation Physician in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Physical Medicine & Rehabilitation Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.