Individual provider Active NPI

Mariko Nomura

  • Emergency Medicine Physician
  • Oakland, CA
National Provider Identifier
1376977298
Registry record updated Oct 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A154436 Issued in CA
Practice address
1411 E 31St St
Qic 22123
Oakland, CA 94602-1018
Phone
(510) 437-4564
NPI assigned
Aug 27, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A154436 CA Primary

Addresses

Primary practice location

1411 E 31St St
Qic 22123
Oakland, CA 94602-1018

Mailing address

1411 E 31St St
Qic 22123
Oakland, CA 94602-1018
Phone (510) 437-4564

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address manomura@alamedahealthsystem.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20191216001912 CA Practitioner - Emergency Medicine 5698109106 Reassigns benefits to 1 organization
I20210223002765 TX Practitioner - Emergency Medicine 5698109106 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Oregon Health Sciences University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DHHS PHS Naihs Shiprock HospitalGroup PAC ID 0749193837, 148 clinicians

Practice addresses (Care Compare)

Highway 491
Shiprock, NM 87420-0160
Phone 50536860016401

P O Box
160 Attn Business Office
Shiprock, NM 87420-0160

PO Box
Suite 160
Shiprock, NM 87420-0160

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A154436CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS IHS Phoenix Area Current Accepting new patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince Dec 24, 2025 Accepting new patients
Team Physicians of California Medical Group Inc Emergency Medicine CurrentSince Oct 1, 2019 Accepting new patients
DHHS IHS Phoenix Area CurrentSince Feb 16, 2021 Accepting new patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince Dec 24, 2025 Accepting new patients

Locations

975 S Fairmont Ave
Lodi, CA 95240
Phone (209) 339-7575

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 5

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": "1377561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570665600000",
    "number": "1376977298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 E 31ST ST",
            "address_2": "QIC 22123",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946021018",
            "telephone_number": "510-437-4564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 E 31ST ST",
            "address_2": "QIC 22123",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946021018",
            "telephone_number": "510-437-4564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOMURA",
        "first_name": "MARIKO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-27",
        "last_updated": "2019-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A154436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "manomura@alamedahealthsystem.org",
            "affiliation": "N",
            "address_1": "1411 E 31st St",
            "address_2": "QIC 22123",
            "city": "Oakland",
            "state": "CA",
            "country_code": "US",
            "postal_code": "946021018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.