Individual provider Active NPI

Ian Patrick Hoffman, MD

  • Family Medicine Physician
  • Oakland, CA
National Provider Identifier
1457550956
Registry record updated Mar 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A101932 Issued in CA
Practice address
3451 E. 12TH Street
Oakland, CA 94601
Phone
(510) 535-3319
Fax
(510) 535-4187
NPI assigned
Jul 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2022

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 A101932 CA Primary

Addresses

Primary practice location

3451 E. 12TH Street
Oakland, CA 94601

Mailing address

1601 Fruitvale Ave
Oakland, CA 94601
Phone (510) 535-4000

Other practice location 1

632 Broadway Ph
New York, NY 10012-2614
Phone (800) 731-4254

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR, GA, CT4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20170809003533 WA Practitioner - Family Practice 3678605300 Reassigns benefits to 1 organization
I20170809003745 OR Practitioner - Family Practice 3678605300 Reassigns benefits to 1 organization
I20241219002191 GA Practitioner - Family Practice 3678605300 Reassigns benefits to 1 organization
I20250428002371 CT Practitioner - Family Practice 3678605300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A101932CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Jul 17, 2017 Accepting new patients
Galileo Medical Group Ga, P.C. Family Medicine CurrentSince Sep 9, 2024 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Family Medicine CurrentSince Jul 17, 2017 Accepting new patients

Locations

4300 Paces Ferry Rd SE
Ste 500
Atlanta, GA 30339
Phone (404) 496-8960

64 Bleecker St
New York, NY 10012
Phone (302) 313-1584

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

3550 N Interstate Ave
Portland, OR 97227
Phone (503) 285-9321

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

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": "1184284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647388800000",
    "number": "1457550956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 FRUITVALE AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "94601",
            "telephone_number": "510-535-4000",
            "fax_number": "510-535-4128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3451 E. 12TH STREET",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "94601",
            "telephone_number": "510-535-3319",
            "fax_number": "510-535-4187"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "632 Broadway Ph",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100122614",
            "country_code": "US",
            "telephone_number": "800-731-4254",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOFFMAN",
        "first_name": "IAN",
        "middle_name": "PATRICK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-13",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A101932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.