NPIMap

Individual provider Active NPI

Marcia C Peck, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Castro Valley, CA
National Provider Identifier
1376569475
Registry record updated Mar 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
A75655 Issued in CA
Practice address
20130 Lake Chabot Rd
Suite 201
Castro Valley, CA 94546-5340
Phone
(510) 204-2574
Fax
(510) 886-8466
NPI assigned
Jul 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X A75655 CA Primary

Addresses

Primary practice location

20130 Lake Chabot Rd
Suite 201
Castro Valley, CA 94546-5340

Mailing address

20130 Lake Chabot Rd
Suite 201
Castro Valley, CA 94546-5340
Phone (510) 204-2574

Other identifiers 1

IdentifierTypeStateIssuer
A75655OtherCAMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040122000616 CA Practitioner - EndocrinologyPractitioner - Internal Medicine 7315849189 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
University of Chicago, Pritzker School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

12 Camino Encinas
Orinda, CA 94563-3304
Phone (510) 204-8180

20101 Lake Chabot Rd
Castro Valley, CA 94546-5305
Phone (510) 886-3400

20103 Lake Chabot Rd
Castro Valley, CA 94546-5305
Phone (510) 727-3256

20130 Lake Chabot Rd
Castro Valley, CA 94546-5340

3200 Kearney St
Fremont, CA 94538-2299
Phone (510) 490-1222

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation CurrentSince Aug 1, 2017 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Aug 1, 2017 Accepting new patients
Avant Inpatient Services Medical Group, Inc Past Accepting new patients
Eden Medical Center/San Leandro Hospital Campus Past Accepting new patients
Marin General Hospital Past Accepting new patients
El Camino Hospital Past Accepting new patients

Locations

2001 Dwight Way
Berkeley, CA 94704
Phone (510) 204-1880

20101 Lake Chabot Rd
Fl 4
Castro Valley, CA 94546
Phone (510) 204-3410

20101 Lake Chabot Rd
Fl 3
Castro Valley, CA 94546
Phone (510) 886-3400

20130 Lake Chabot Rd
Ste 201
Castro Valley, CA 94546
Phone (510) 886-3400

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

3687 Mt Diablo Blvd
Ste 200
Lafayette, CA 94549
Phone (510) 204-6660

370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200

12 Camino Encinas
Orinda, CA 94563
Phone (510) 204-8180

795 El Camino Real
#1112
Palo Alto, CA 94301

Interoperability endpoints

  • Direct secure messaging: mpeck77796@hisp.ehr.sutterhealth.org

Organizations & group practices 6

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 11

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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299801600000",
    "number": "1376569475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20130 LAKE CHABOT RD",
            "address_2": "SUITE 201",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945465340",
            "telephone_number": "510-204-2574",
            "fax_number": "510-886-8466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20130 LAKE CHABOT RD",
            "address_2": "SUITE 201",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945465340",
            "telephone_number": "510-204-2574",
            "fax_number": "510-886-8466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "MARCIA",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2011-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CA",
            "license": "A75655",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "A75655",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Castro Valley, CA

Sources for this page

Verify at the official NPI Registry.