Individual provider Active NPI

Diana F. Enrile, MD

  • Pediatrics Physician
  • Manteca, CA
National Provider Identifier
1518045400
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A52366 Issued in CA
Practice address
1721 W Yosemite Ave
Manteca, CA 95337-5130
Phone
(209) 476-2000
NPI assigned
Nov 1, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A52366 CA Primary

Addresses

Primary practice location

1721 W Yosemite Ave
Manteca, CA 95337-5130

Mailing address

1800 Harrison St FL 7
Oakland, CA 94612-3429
Phone (510) 625-6262

Other identifiers 1

IdentifierTypeStateIssuer
00A523660MedicaidCA

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
I20101213001106 CA Practitioner - Pediatric Medicine 5294922506 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A52366CAMDPediatrics Physician
52366CAMDSports Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc Pediatrics Current Accepting new patients
Permanente Medical Group, Inc CurrentSince Oct 12, 2010 Accepting new patients
Community Medical Centers, Inc. CurrentSince Jul 30, 2019 Accepting new patients
Community Medical Centers, Inc. Current Accepting new patients
Permanente Medical Group Inc Pediatrics CurrentSince Oct 12, 2010 Accepting new patients
Community Medical Centers Inc CurrentSince Jul 30, 2019 Accepting new patients

Locations

1721 W Yosemite Ave
Manteca, CA 95337
Phone (209) 476-2000

1800 Harrison St
Fl 7
Oakland, CA 94612

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

7210 Murray Dr
Stockton, CA 95210
Phone (209) 373-2816

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

730 N Central Ave
Tracy, CA 95376
Phone (209) 820-1500

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

Interoperability endpoints

  • Direct secure messaging: denrile768143@direct.ochin.org
  • Direct secure messaging: diana.enrile.p1@direct.cmcentersinc.nextgenshare.com

Organizations & group practices 6

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1518045400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 HARRISON ST FL 7",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946123429",
            "telephone_number": "510-625-6262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 W YOSEMITE AVE",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953375130",
            "telephone_number": "209-476-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENRILE",
        "first_name": "DIANA",
        "middle_name": "F.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A52366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A523660",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manteca, CA

Sources for this page

Verify at the official NPI Registry.