Individual provider Active NPI

Nicole Moralde

  • Family Nurse Practitioner
  • Oakland, CA
National Provider Identifier
1508480120
Registry record updated Dec 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95013826 Issued in CA
Practice address
3100 Summit St Ste 2549
Oakland, CA 94609-3412
Phone
(510) 869-6656
NPI assigned
May 29, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95158487 CA
Family Nurse Practitioner 363LF0000X 95013826 CA Primary

Addresses

Primary practice location

3100 Summit St Ste 2549
Oakland, CA 94609-3412

Mailing address

3200 Benjamin Dr
Richmond, CA 94806-2773
Phone (510) 589-0536

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210201001950 CA Practitioner - Nurse Practitioner 6507270675 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

3100 Summit St
FL 2
Oakland, CA 94609-3412
Phone (510) 869-8865

3200 Kearney St
Fremont, CA 94538-2299
Phone (510) 490-1222

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95013826CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
La Clinica de la Raza Inc Current Accepting new patients
Sutter Bay Medical Foundation CurrentSince Sep 12, 2022 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Dec 13, 2022 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Sep 12, 2022 Accepting new patients
Alta Bates Summit Medical Center Past Accepting new patients
Sutter East Bay Medical Foundation Past Accepting new patients
Sutter East Bay Medical Foundation PastSince Dec 13, 2022 Accepting new patients

Locations

18400 US Highway 18
Apple Valley, CA 92307
Phone (760) 810-7590

350 John Muir Pkwy
Ste 160
Brentwood, CA 94513
Phone (925) 204-1920

1950 University Ave
Ste 160
East Palo Alto, CA 94303
Phone (650) 317-8100

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

1189 E Herndon Ave
Ste 103
Fresno, CA 93720
Phone (559) 450-7777

370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200

600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755

101 Rowland Way
Ste 220
Novato, CA 94945
Phone (415) 878-7200

1515 Fruitvale Ave
Oakland, CA 94601
Phone (510) 535-6300

3100 Summit St
Ste 2549
Oakland, CA 94609
Phone (510) 869-6656

3100 Summit St
Fl 2
Oakland, CA 94609
Phone (510) 869-8400

795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832

1555 East St
Ste 200
Redding, CA 96001
Phone (530) 229-0911

151 N Sunrise Ave
Ste 1205
Roseville, CA 95661
Phone (916) 789-1505

3838 California St
Rm 410
San Francisco, CA 94118
Phone (415) 751-1847

123 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 343-4200

3883 Airway Dr
Ste 220
Santa Rosa, CA 95403
Phone (707) 521-7750

10200 Trinity Pkwy
Ste 101
Stockton, CA 95219
Phone (209) 323-3488

Interoperability endpoints

  • Direct secure messaging: nmoralde571862@hisp.ehr.sutterhealth.org

Organizations & group practices 7

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1590710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670371200000",
    "number": "1508480120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 BENJAMIN DR",
            "city": "RICHMOND",
            "state": "CA",
            "postal_code": "948062773",
            "telephone_number": "510-589-0536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 SUMMIT ST STE 2549",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093412",
            "telephone_number": "510-869-6656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORALDE",
        "first_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-29",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95158487",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95013826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.