Individual provider Active NPI

Uri Elie Cohen, M.D.

  • Child & Adolescent Psychiatry Physician
  • San Rafael, CA
National Provider Identifier
1396964532
Registry record updated Sep 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
A104583 Issued in CA
Practice address
3230 Kerner Blvd
San Rafael, CA 94901-4840
Phone
(415) 473-7249
NPI assigned
Apr 25, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 241902 NY
Child & Adolescent Psychiatry Physician 2084P0804X A104583 CA Primary

Addresses

Primary practice location

3230 Kerner Blvd
San Rafael, CA 94901-4840

Mailing address

2050 Fairmont Dr
San Leandro, CA 94578-1001
Phone (415) 473-7249

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
104583CAMDOrthodontics and Dentofacial Orthopedic Dentist
241902NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rocketship Education Wisconsin Inc. Past Accepting new patients
Seneca Family of Agencies Past Accepting new patients
Seneca Family of Agencies Past Accepting new patients
Seneca Center Past Accepting new patients

Organizations & group practices 4

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": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475193600000",
    "number": "1396964532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 FAIRMONT DR",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945781001",
            "telephone_number": "415-473-7249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3230 KERNER BLVD",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949014840",
            "telephone_number": "415-473-7249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHEN",
        "first_name": "URI",
        "middle_name": "ELIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-25",
        "last_updated": "2016-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "241902",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "A104583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.