Individual provider Active NPI

Anthony Digiovanni, M.D.

  • Child & Adolescent Psychiatry Physician
  • Berkeley, CA
National Provider Identifier
1376642769
Registry record updated Jun 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
A87688 Issued in CA
Practice address
2001 Dwight Way
Berkeley, CA 94704-2608
Phone
(510) 204-4635
Fax
(510) 204-3060
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X A87688 CA Primary

Addresses

Primary practice location

2001 Dwight Way
Berkeley, CA 94704-2608

Mailing address

2001 Dwight Way
Berkeley, CA 94704-2608
Phone (510) 204-4635

Other identifiers 2

IdentifierTypeStateIssuer
J400066800OtherNYMEDICARE GROUP J100044293
03446917MedicaidNY

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
I20041210000589 CA Practitioner - Psychiatry 4082671169 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
George Washington University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bay Psychiatric AssociatesGroup PAC ID 6204723331, 60 clinicians

Practice addresses (Care Compare)

2001 Dwight Way
RM 4190
Berkeley, CA 94704-2608
Phone (510) 204-4635

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A87688CAMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bay Psychiatric Associates CurrentSince Jul 26, 2016 Accepting new patients

Locations

2020 Milvia St
Ste 440
Berkeley, CA 94704
Phone (510) 204-4635

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

2001 Dwight Way
Rm 4190
Berkeley, CA 94704
Phone (510) 204-4635

2001 Dwight Way
Fl 4
Berkeley, CA 94704
Phone (510) 204-2461

2001 Dwight Way
Ste 4190
Berkeley, CA 94704
Phone (510) 204-4635

350 Hawthorne Ave
Oakland, CA 94609
Phone (510) 655-4000

Interoperability endpoints

  • Direct secure messaging: adigiovanni264772@hisp.ehr.sutterhealth.org

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.

Hospital & facility affiliations 1

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466035200000",
    "number": "1376642769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 DWIGHT WAY",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947042608",
            "telephone_number": "510-204-4635",
            "fax_number": "510-204-3060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 DWIGHT WAY",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947042608",
            "telephone_number": "510-204-4635",
            "fax_number": "510-204-3060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIGIOVANNI",
        "first_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2016-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "A87688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP J100044293",
            "identifier": "J400066800",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03446917",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.