Individual provider Active NPI

Robert A. Cooper, MD

  • Interventional Cardiology Physician
  • Oakland, CA
National Provider Identifier
1295813079
Registry record updated Sep 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
G45981 Issued in CA
Practice address
275 W Macarthur
Oakland, CA 94611-5641
Phone
(510) 752-1000
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X G45981 CA Primary

Addresses

Primary practice location

275 W Macarthur
Oakland, CA 94611-5641

Mailing address

275 W Macarthur
Oakland, CA 94611-5641
Phone (510) 752-1000

Other identifiers 1

IdentifierTypeStateIssuer
00G459810MedicaidCA

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
I20110413000869 CA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 8820272966 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
45981CAMDEndodontist
G45981CAMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aristamd CurrentSince Apr 1, 2021 Accepting new patients

Locations

4755 Nexus Center Dr
San Diego, CA 92121
Phone (858) 750-4777

Organizations & group practices 1

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410825600000",
    "number": "1295813079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 W MACARTHUR",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946115641",
            "telephone_number": "510-752-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 W MACARTHUR",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946115641",
            "telephone_number": "510-752-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "ROBERT",
        "middle_name": "A.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2014-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CA",
            "license": "G45981",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G459810",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.