Individual provider Active NPI

Elizabeth Cooper, R.D., PA-C

  • Medical Physician Assistant
  • Oakland, CA
National Provider Identifier
1396828539
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
20830 Issued in CA
Practice address
3300 Webster St Ste 710
Oakland, CA 94609-3122
Phone
(510) 465-5800
NPI assigned
Oct 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 20830 CA Primary

Addresses

Primary practice location

3300 Webster St Ste 710
Oakland, CA 94609-3122

Mailing address

3016 Santa Clara Ave
Alameda, CA 94501-3138
Phone (601) 862-2000

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180628001254 CA Practitioner - Physician Assistant 3870595143 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bass Medical Group CurrentSince Jan 1, 2019 Accepting new patients
Bass Medical Group CurrentSince Jan 1, 2019 Accepting new patients
Jumpstart Medicine PC Past Accepting new patients
Bass Medical Group Past Accepting new patients
Peter a. Castillo, MD, Inc. PastSince Jun 1, 2024 Accepting new patients
Bass Medical Group Past Accepting new patients

Locations

1505 Saint Alphonsus Way
Alamo, CA 94507
Phone (925) 837-4225

3300 Webster St
Ste 710
Oakland, CA 94609
Phone (510) 465-5800

Interoperability endpoints

  • Direct secure messaging: ecooper112812@ehr.johnmuirhealth.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/IBDGCA

Organizations & group practices 7

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1396828539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3016 SANTA CLARA AVE",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945013138",
            "telephone_number": "601-862-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 WEBSTER ST STE 710",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093122",
            "telephone_number": "510-465-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "ELIZABETH",
        "credential": "R.D., PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "20830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.