Individual provider Active NPI

Shanti Karuna Leon Guerrero, MD/MPH

  • Family Medicine Physician
  • Oakland, CA
National Provider Identifier
1386033090
Registry record updated Mar 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A155088 Issued in CA
Practice address
3451 E 12TH St
Oakland, CA 94601-3463
Phone
(510) 535-3500
Fax
(510) 535-3319
NPI assigned
Jan 19, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A155088 CA Primary

Addresses

Primary practice location

3451 E 12TH St
Oakland, CA 94601-3463

Mailing address

PO Box 22210
Oakland, CA 94623-2210
Phone (510) 535-4000

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
I20190702001741 CA Practitioner - Family Practice 1557695145 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Northwestern University Feinberg Medical School, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
La Clinica de la Raza IncGroup PAC ID 1557258282, 130 clinicians

Practice addresses (Care Compare)

3451 E 12TH St
Oakland, CA 94601-3463
Phone (510) 535-3500

Hospital & facility affiliations

  • Ace Home Health Care & Hospice, Inc Home health agency, Orinda, CA, CCN 059461
  • Alta Bates Summit Medical Center - Alta Bates Camp Hospital, Berkeley, CA, CCN 050305
  • Alta Bates Summit Medical Center Hospital, Oakland, CA, CCN 050043

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A155088CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Santa Clara Current Accepting new patients
County of Santa Clara CurrentSince Mar 1, 2020 Accepting new patients
La Clinica de la Raza Inc CurrentSince Aug 1, 2019 Accepting new patients
La Clinica de la Raza Inc CurrentSince Aug 1, 2019 Accepting new patients
La Clinica de la Raza Inc Current Accepting new patients
County of Santa Clara CurrentSince Mar 1, 2020 Accepting new patients
County of Santa Clara Family Medicine Current Accepting new patients
County of Santa Clara CurrentSince Mar 1, 2020 Accepting new patients
County of Santa Clara CurrentSince Mar 1, 2020 Accepting new patients
La Clinica de la Raza, Inc. Past Accepting new patients

Locations

7475 Camino Arroyo
Gilroy, CA 95020
Phone (408) 852-2400

3451 E 12th St
Fl 2
Oakland, CA 94601
Phone (510) 535-3319

3451 E 12th St
Oakland, CA 94601
Phone (510) 535-3319

1993 McKee Rd
San Jose, CA 95116
Phone (408) 254-6320

1996 Lundy Ave
San Jose, CA 95131
Phone (408) 299-5846

500 Tully Rd
San Jose, CA 95111
Phone (408) 817-1433

750 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-2320

2101 Alexian Dr
San Jose, CA 95116
Phone (408) 272-6050

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

660 S Fair Oaks Ave
Sunnyvale, CA 94086
Phone (408) 885-7366

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: sleonguerrero308539@direct.ochin.org
  • Direct secure messaging: sleonguerrero468543@hisp.ehr.sutterhealth.org

Organizations & group practices 11

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 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": "1421625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1386033090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22210",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946232210",
            "telephone_number": "510-535-4000",
            "fax_number": "510-535-4189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3451 E 12TH ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946013463",
            "telephone_number": "510-535-3500",
            "fax_number": "510-535-3319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEON GUERRERO",
        "first_name": "SHANTI",
        "middle_name": "KARUNA",
        "credential": "MD/MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-19",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A155088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.