Alan Russ Gottlieb, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

A34546 Issued in CA

Practice address

20103 Lake Chabot Rd
Castro Valley, CA 94546-5341

Phone

(209) 342-2300

Fax

(209) 524-4240

NPI assigned

Nov 4, 2005

Last updated

Aug 11, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Family PracticeAlso: Emergency Medicine

Education

University of Michigan Medical School, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Stat Med PC a California Medical Professional CorporationGroup PAC ID 1850528530, 15 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

21.28 of 100Reported as individual

Quality

0

Promoting interoperability

0

Improvement activities

0

Cost

70.93

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Stat Med PC a California Medical Professional Corporation

  • Urgent Care Clinic/Center
  • Lafayette, CA
  • NPI 1891132106
  Medicare reassignment Care Compare group NPD
• Eden Emergency Medical Group Inc

  • Emergency Medicine Physician
  • Castro Valley, CA
  • NPI 1891786240
  NPD
• Stat Med PC a California Medical Professional Corporation

  • Urgent Care Clinic/Center
  • Brentwood, CA
  • NPI 1265169643
  NPD
• John Muir Health

  • Rehabilitation Hospital Unit
  • Walnut Creek, CA
  • NPI 1447269303
  NPD (past)

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218412800000",
    "number": "1306837521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 NORTHSTAR WAY",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569262",
            "telephone_number": "209-342-2300",
            "fax_number": "209-524-4240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20103 LAKE CHABOT RD",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945465341",
            "telephone_number": "209-342-2300",
            "fax_number": "209-524-4240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTTLIEB",
        "first_name": "ALAN",
        "middle_name": "RUSS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-04",
        "last_updated": "2008-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A34546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00A345460",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A345460",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenneth Dwayne Gordon, LVN
• Gahfora Gorsi, NP
• Gretchen Gossett
• Laurie J Gossett, DC
• Caryn Day Gottfried, MFT
• Benjamin Micah Graf, LCSW
• Elmer Jason Ocampo Grande, MD
• Scott A. Greenberg, M.D.
• Harkiran K Grewal, MD
• Angela Griffiths, D.C.

• Emergency Medicine Physician in Castro Valley, CA
• Providers in Castro Valley, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2008; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.