Active NPI
Alameda Anesthesia Associates Medical Group, Inc
- Anesthesiology Physician
- Castro Valley, CA
National Provider Identifier
1487602256
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- N/A
- Legal business name
- ALAMEDA ANESTHESIA ASSOCIATES MEDICAL GROUP, INC
- Practice address
- 20103 Lake Chabot Rd
Castro Valley, CA 94546-5341 - Phone
- (510) 537-1234
- Fax
- (510) 727-2786
- NPI assigned
- May 4, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. David Karl Black, MD
- Title
- President
- Phone
- (503) 372-2740
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | N/A | Primary |
Addresses
Primary practice location
20103 Lake Chabot Rd
Castro Valley, CA 94546-5341
Mailing address
8905 SW Nimbus Ave
Ste 300
Beaverton, OR 97008-7136
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040922001142 | CA | Part B Supplier - Clinic/Group Practice | 4688642028 |
Receives reassigned benefits from 30 practitioners Practice locations: Fremont, CA; San Leandro, CA; Modesto, CA; Hayward, CA; Castro Valley, CA |
National Provider Directory
National Provider DirectoryLocations
20998 Redwood Rd
Castro Valley, CA 94546
Phone (510) 538-2828
Practitioners & affiliated clinicians
Practitioners 31
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146700800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1230508800000",
"number": "1487602256",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8905 SW NIMBUS AVE",
"address_2": "STE 300",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970087136"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20103 LAKE CHABOT RD",
"city": "CASTRO VALLEY",
"state": "CA",
"postal_code": "945465341",
"telephone_number": "510-537-1234",
"fax_number": "510-727-2786"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ALAMEDA ANESTHESIA ASSOCIATES MEDICAL GROUP, INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-04",
"last_updated": "2008-12-29",
"status": "A",
"authorized_official_last_name": "BLACK",
"authorized_official_first_name": "DAVID",
"authorized_official_middle_name": "KARL",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "503-372-2740",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Anesthesiology",
"state": null,
"license": "N/A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Castro Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.