Individual provider Active NPI

Lyn E Berry, MD

  • Internal Medicine Physician
  • Oakland, CA
National Provider Identifier
1528078193
Registry record updated Jan 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G50678 Issued in CA
Practice address
1411 E 31St Street
Oakcare Medical Group
Oakland, CA 94602-1080
Phone
(510) 437-4323
Fax
(510) 437-5042
NPI assigned
Aug 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G50678 CA Primary

Addresses

Primary practice location

1411 E 31St Street
Oakcare Medical Group
Oakland, CA 94602-1080

Mailing address

1411 E 31St Street
Oakcare Medical Group
Oakland, CA 94602-1080
Phone (510) 437-4323

Other identifiers 1

IdentifierTypeStateIssuer
00G506780MedicaidCA

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
I20080703000206 CA Practitioner - Internal Medicine 3476625674 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G50678CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alameda Health System Current Accepting new patients
Alameda Health System CurrentSince Mar 13, 2013 Accepting new patients
Alameda Health System CurrentSince Mar 13, 2013 Accepting new patients

Locations

2070 Clinton Ave
Alameda, CA 94501
Phone (510) 522-3700

15400 Foothill Blvd
Bldg E
Castro Valley, CA 94578
Phone (510) 895-4200

664 Southland Mall
Hayward, CA 94545
Phone (510) 266-1700

6066 Civic Terrace Ave
Newark, CA 94560
Phone (510) 505-1600

6955 Foothill Blvd
Ste 200
Oakland, CA 94605
Phone (510) 567-5700

1411 E 31st St
Oakland, CA 94602
Phone (510) 437-4323

Interoperability endpoints

  • Direct secure messaging: lberry9951@alamedahs.direct-ci.com

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": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326240000000",
    "number": "1528078193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 E 31ST STREET",
            "address_2": "OAKCARE MEDICAL GROUP",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946021080",
            "telephone_number": "510-437-4323",
            "fax_number": "510-437-5042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 E 31ST STREET",
            "address_2": "OAKCARE MEDICAL GROUP",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946021080",
            "telephone_number": "510-437-4323",
            "fax_number": "510-437-5042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "LYN",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2012-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G50678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G506780",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.