Individual provider Active NPI

John Alan Puccini, PA-C

  • Medical Physician Assistant
  • Walnut Creek, CA
National Provider Identifier
1528351814
Registry record updated May 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA21529 Issued in CA
Practice address
106 La Casa Via Ste 140
Walnut Creek, CA 94598-3084
Phone
(925) 274-2860
NPI assigned
May 19, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA21529 CA Primary

Addresses

Primary practice location

106 La Casa Via Ste 140
Walnut Creek, CA 94598-3084

Mailing address

106 La Casa Via Ste 140
Walnut Creek, CA 94598-3084
Phone (925) 274-2860

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
I20120830000205 CA Practitioner - Physician Assistant 2567619364 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alameda Health SystemGroup PAC ID 3779494521, 597 clinicians

Practice addresses (Care Compare)

1411 E 31St St
Oakland, CA 94602-1018
Phone (510) 437-4800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.17 of 100Reported as group
Quality
86.93
Promoting interoperability
100
Improvement activities
40
Cost
72.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA21529CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Alameda Health System CurrentSince Jul 23, 2012 Accepting new patients
Alameda Health System CurrentSince Jul 23, 2012 Accepting new patients
Alameda Health System Past Accepting new patients
Stanford Hospital and Clinics Past Accepting new patients

Locations

15400 Foothill Blvd
Castro Valley, CA 94578
Phone (510) 346-1468

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: jpuccini12796@alamedahs.direct-ci.com

Organizations & group practices 5

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 3

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": "1305763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305763200000",
    "number": "1528351814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 LA CASA VIA STE 140",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983084",
            "telephone_number": "925-274-2860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 LA CASA VIA STE 140",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983084",
            "telephone_number": "925-274-2860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUCCINI",
        "first_name": "JOHN",
        "middle_name": "ALAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-19",
        "last_updated": "2011-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA21529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

Verify at the official NPI Registry.