Individual provider Active NPI

Robert E Belknap, MD

  • Adult Medicine Physician
  • Mill Valley, CA
National Provider Identifier
1336217306
Registry record updated Apr 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
A24275 Issued in CA
Practice address
655 Redwood Hwy
Suite 375
Mill Valley, CA 94941-3034
Phone
(415) 384-0506
NPI assigned
Nov 30, 2006
Last updated
Apr 10, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X A24275 CA Primary

Addresses

Primary practice location

655 Redwood Hwy
Suite 375
Mill Valley, CA 94941-3034

Mailing address

655 Redwood Hwy
Suite 375
Mill Valley, CA 94941-3034
Phone (415) 384-0506

Other identifiers 1

IdentifierTypeStateIssuer
00A242750MedicaidCA

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
I20080423000434 CA Practitioner - Internal Medicine 4981782414 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of California, San Francisco School of Medicine, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

655 Redwood Hwy
Suite 375
Mill Valley, CA 94941-3041
Phone (415) 384-0506

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A24275CAMDAdult Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Robert E Belknap MD Inc CurrentSince Sep 1, 2007 Accepting new patients
Marin General Hospital Past Accepting new patients

Locations

655 Redwood Hwy Frontage Rd
Ste 375
Mill Valley, CA 94941
Phone (415) 212-8332

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207785600000",
    "number": "1336217306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 REDWOOD HWY",
            "address_2": "SUITE 375",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949413034",
            "telephone_number": "415-384-0506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 REDWOOD HWY",
            "address_2": "SUITE 375",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949413034",
            "telephone_number": "415-384-0506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELKNAP",
        "first_name": "ROBERT",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2008-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "CA",
            "license": "A24275",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A242750",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mill Valley, CA

Sources for this page

Verify at the official NPI Registry.