Individual provider Active NPI

Helen Kalasa Mwanza, NP

  • Family Nurse Practitioner
  • Berkeley, CA
National Provider Identifier
1538635966
Registry record updated Nov 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP95009265 Issued in CA
Practice address
2905 Telegraph Ave
Berkeley, CA 94705-2017
Phone
(510) 841-4525
Fax
(510) 848-9970
NPI assigned
Oct 24, 2018
Last updated
Nov 5, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP95009265 CA Primary

Addresses

Primary practice location

2905 Telegraph Ave
Berkeley, CA 94705-2017

Mailing address

2905 Telegraph Ave
Berkeley, CA 94705-2017
Phone (510) 841-4525

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
I20190104002779 CA Practitioner - Nurse Practitioner 1052657442 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Coast KidneyGroup PAC ID 1759700149, 56 clinicians

Practice addresses (Care Compare)

2370 Country Hills Dr
Suite 101
Antioch, CA 94509-7436
Phone (925) 779-9635

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP95009265CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
East Bay Nephrology Medical Group, Inc. CurrentSince Nov 15, 2018 Accepting new patients
East Bay Nephrology Medical Group, Inc. CurrentSince Nov 15, 2018 Accepting new patients
West Coast Kidney CurrentSince Nov 10, 2022 Accepting new patients
Diablo Nephrology Medical Group, Inc PastSince Nov 10, 2022 Accepting new patients

Locations

2370 Country Hills Dr
Ste 101
Antioch, CA 94509
Phone (925) 779-9635

2905 Telegraph Ave
Berkeley, CA 94705
Phone (510) 841-0411

1860 El Camino Real
Ste 321
Burlingame, CA 94010
Phone (650) 552-8180

2250 Hayes St
Ste 612
San Francisco, CA 94117
Phone (415) 268-3208

125 Hospital Dr
Vallejo, CA 94589
Phone (707) 642-7510

Interoperability endpoints

  • Direct secure messaging: helen.mwanza.1@8243.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/11865/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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": "1540339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541376000000",
    "number": "1538635966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2905 TELEGRAPH AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052017",
            "telephone_number": "510-841-4525",
            "fax_number": "510-848-9970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2905 TELEGRAPH AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052017",
            "telephone_number": "510-841-4525",
            "fax_number": "510-848-9970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MWANZA",
        "first_name": "HELEN",
        "middle_name": "KALASA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-24",
        "last_updated": "2018-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95009265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.