Individual provider Active NPI

Anna Kristina O'Malley, M.D.

  • Family Medicine Physician
  • Stinson Beach, CA
National Provider Identifier
1447459185
Registry record updated Dec 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A100464 Issued in CA
Practice address
3419 State Route 1
Stinson Beach, CA 94970
Phone
(415) 663-8781
NPI assigned
Jul 13, 2007
Last updated
Dec 30, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2010

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 A100464 CA Primary

Addresses

Primary practice location

3419 State Route 1
Stinson Beach, CA 94970

Mailing address

202 Miramar Ave
San Rafael, CA 94901-3675
Phone (415) 847-4720

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
I20090825000682 CA Practitioner - Family Practice 7113072224

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A100464CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Health Alliance CurrentSince Apr 14, 2013 Accepting new patients
Coastal Health Alliance Family Medicine CurrentSince Apr 14, 2013 Accepting new patients
Coastal Health Alliance Past Accepting new patients
Petaluma Health Center Inc Past Accepting new patients
Petaluma Health Center Inc Past Accepting new patients

Locations

88 Mesa Rd
Bolinas, CA 94924
Phone (415) 663-8666

Interoperability endpoints

  • Direct secure messaging: aomalley613937@direct.ochin.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1184284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293667200000",
    "number": "1447459185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 MIRAMAR AVE",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949013675",
            "telephone_number": "415-847-4720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3419 STATE ROUTE 1",
            "city": "STINSON BEACH",
            "state": "CA",
            "postal_code": "94970",
            "telephone_number": "415-663-8781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'MALLEY",
        "first_name": "ANNA",
        "middle_name": "KRISTINA",
        "name_prefix": "Ms.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-13",
        "last_updated": "2010-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A100464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stinson Beach, CA

Sources for this page

Verify at the official NPI Registry.