NPIMap

Organization Active NPI

Berkeley Emergency Medical Group, Inc.

  • Emergency Medicine Physician
  • Oakland, CA
National Provider Identifier
1508874454
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
BERKELEY EMERGENCY MEDICAL GROUP, INC.
Practice address
350 Hawthorne Ave
Oakland, CA 94609-3108
Phone
(877) 346-2211
Fax
(925) 962-1801
NPI assigned
Aug 4, 2006
Last updated
Jun 17, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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

Authorized official

Name
Steve M Sornsin, MD
Title
President
Phone
(510) 655-4000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU Primary

Addresses

Primary practice location

350 Hawthorne Ave
Oakland, CA 94609-3108

Mailing address

PO Box 920139
Dallas, TX 75392-0139
Phone (877) 346-2211

Other identifiers 1

IdentifierTypeStateIssuer
GR0065881MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040123000216 CA Part B Supplier - Clinic/Group Practice 5890697536 Receives reassigned benefits from 53 practitioners
1 other NPI on this enrollment
Practice locations: Berkeley, CA; Oakland, CA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 184

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 184

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718582400000",
    "number": "1508874454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 920139",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753920139",
            "telephone_number": "877-346-2211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 HAWTHORNE AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093108",
            "telephone_number": "877-346-2211",
            "fax_number": "925-962-1801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERKELEY EMERGENCY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A",
        "authorized_official_last_name": "SORNSIN",
        "authorized_official_first_name": "STEVE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "510-655-4000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0065881",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2024; 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.

Verify at the official NPI Registry.