Individual provider Active NPI

Rebecca Matta, MD

  • Pediatrics Physician
  • Oakland, CA
National Provider Identifier
1407421860
Registry record updated May 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A194404 Issued in CA
Practice address
747 52ND St
Oakland, CA 94609-1809
Phone
(510) 428-3129
NPI assigned
May 26, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X C7-0017601 DE
Pediatrics Physician 208000000X A194404 CA Primary

Addresses

Primary practice location

747 52ND St
Oakland, CA 94609-1809

Mailing address

747 52ND St
Oakland, CA 94609-1809
Phone (510) 428-3129

Other practice location 1

1600 Rockland Rd Ste 3D16
Wilmington, DE 19803-3607
Phone (302) 651-5874

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
I20240524001620 CA Practitioner - Pediatric Medicine 5698179042 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C7-0017601DEMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents Univ of California UCSF Pediatrics CurrentSince May 13, 2024 Accepting new patients
UCSF Health Medical Foundation Pediatrics CurrentSince Aug 10, 2024 Accepting new patients
UCSF Health Medical Foundation Past Accepting new patients

Locations

747 52nd St
Oakland, CA 94609
Phone (510) 428-3070

570 Price Ave
Ste 100
Redwood City, CA 94063
Phone (650) 327-1258

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

3838 California St
Rm 111
San Francisco, CA 94118
Phone (415) 221-6476

1081 Market Pl
Ste 500
San Ramon, CA 94583
Phone (669) 235-4188

Organizations & group practices 3

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": "1621987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715904000000",
    "number": "1407421860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "747 52ND ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946091809",
            "telephone_number": "510-428-3129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 52ND ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946091809",
            "telephone_number": "510-428-3129"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 Rockland Rd Ste 3D16",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "DE",
            "postal_code": "198033607",
            "country_code": "US",
            "telephone_number": "302-651-5874",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATTA",
        "first_name": "REBECCA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-26",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "DE",
            "license": "C7-0017601",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A194404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.