Individual provider Active NPI

Golaun Odabaei, M.D

  • Nephrology Physician
  • Berkeley, CA
National Provider Identifier
1306072640
Registry record updated Feb 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A116440 Issued in CA
Practice address
2905 Telegraph Ave
Berkeley, CA 94705-2017
Phone
(510) 841-4525
Fax
(510) 848-9970
NPI assigned
Jun 1, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A116440 CA
Nephrology Physician 207RN0300X A116440 CA Primary

Addresses

Primary practice location

2905 Telegraph Ave
Berkeley, CA 94705-2017

Mailing address

2905 Telegraph Ave
Berkeley, CA 94705-2017
Phone (510) 841-4525

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
I20150225000085 CA Practitioner - NephrologyPractitioner - Internal Medicine 2961728639 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alameda Health SystemGroup PAC ID 3779494521, 597 clinicians

Practice addresses (Care Compare)

6955 Foothill Blvd
Suite 200
Oakland, CA 94605-2426
Phone (510) 567-5704

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A116440CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East Bay Nephrology Medical Group, Inc. Nephrology CurrentSince Feb 1, 2015 Accepting new patients
Alameda Health System Current Accepting new patients
East Bay Nephrology Medical Group, Inc. Nephrology CurrentSince Feb 1, 2015 Accepting new patients
California Pacific Medical Group, Inc. Past Accepting new patients
Alameda Health System Past Accepting new patients

Locations

2905 Telegraph Ave
Berkeley, CA 94705
Phone (510) 841-0411

14400 Olympic Dr
Clearlake, CA 95422
Phone (707) 253-7005

6066 Civic Terrace Ave
Newark, CA 94560
Phone (510) 505-1600

6955 Foothill Blvd
Ste 200
Oakland, CA 94605
Phone (510) 567-5700

350 30th St
Ste 311
Oakland, CA 94609
Phone (510) 465-0941

3012 Summit St
#D
Oakland, CA 94609
Phone (510) 251-1002

1411 E 31st St
Oakland, CA 94602
Phone (510) 437-4323

127 Hospital Dr
Ste 204
Vallejo, CA 94589
Phone (707) 642-7510

125 Hospital Dr
Vallejo, CA 94589
Phone (707) 642-7510

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: godabaei14435@alamedahs.direct-ci.com
  • Direct secure messaging: godabaei232281@hisp.ehr.sutterhealth.org

Organizations & group practices 5

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1243814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455321600000",
    "number": "1306072640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2905 TELEGRAPH AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052017",
            "telephone_number": "510-841-4525",
            "fax_number": "510-848-9970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2905 TELEGRAPH AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052017",
            "telephone_number": "510-841-4525",
            "fax_number": "510-848-9970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODABAEI",
        "first_name": "GOLAUN",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-01",
        "last_updated": "2016-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A116440",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A116440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.