Individual provider Active NPI

Tarquin Alwattar, NP-C

  • Adult Health Nurse Practitioner
  • Oakland, CA
National Provider Identifier
1619242393
Registry record updated Mar 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
21674 Issued in CA
Practice address
384 Embarcadero W
Oakland, CA 94607-3735
Phone
(510) 465-9565
NPI assigned
Mar 14, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 21674 CA Primary

Addresses

Primary practice location

384 Embarcadero W
Oakland, CA 94607-3735

Mailing address

10 Yarmouth CT
Oakland, CA 94619-2434
Phone (917) 456-6675

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
I20120523000687 CA Practitioner - Nurse Practitioner 5799948055 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Julia Graves MD IncGroup PAC ID 1456630284, 3 clinicians
Ani Tajirian MDGroup PAC ID 4082844972, 4 clinicians
Jason F Fung MD a Medical CorporationGroup PAC ID 8426355348, 4 clinicians

Practice addresses (Care Compare)

3300 Webster St
Suite 509
Oakland, CA 94609-3149
Phone (510) 452-0330

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Julia Graves, MD, Inc CurrentSince Oct 27, 2018 Accepting new patients
Lesley Plotke, MD, Inc CurrentSince Dec 1, 2018 Accepting new patients
Ani Tajirian, MD CurrentSince Dec 1, 2018 Accepting new patients
Dermatology Center of the East Bay, Inc. CurrentSince Nov 19, 2024 Accepting new patients
Ingrid Roseborough, MD, PC CurrentSince Oct 27, 2018 Accepting new patients
Jason F Fung, MD, a Medical Corporation CurrentSince Jul 1, 2018 Accepting new patients
Senior Support Services, Inc. Past Accepting new patients

Locations

3511 School St
Lafayette, CA 94549
Phone (510) 452-0330

3300 Webster St
Ste 509
Oakland, CA 94609
Phone (510) 452-0330

Organizations & group practices 7

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": "1331683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331683200000",
    "number": "1619242393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 YARMOUTH CT",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946192434",
            "telephone_number": "917-456-6675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "384 EMBARCADERO W",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946073735",
            "telephone_number": "510-465-9565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALWATTAR",
        "first_name": "TARQUIN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-14",
        "last_updated": "2012-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "21674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.