Individual provider Active NPI

Michael Iocca, D.O.

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Oakland, CA
National Provider Identifier
1629133079
Registry record updated Sep 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
License
20A6072 Issued in CA
Practice address
1411 E 31St St
Oakland, CA 94602-1092
Phone
(510) 437-4893
Fax
(510) 379-7440
NPI assigned
Dec 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 20A6072 CA Primary

Addresses

Primary practice location

1411 E 31St St
Oakland, CA 94602-1092

Mailing address

7677 Oakport St Ste 1200
Oakland, CA 94621-1975
Phone (510) 437-4893

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
I20050715000725 CA Practitioner - Internal Medicine 7517993017 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A6072CAMDHospice and Palliative Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
First Choice Physician Partners CurrentSince May 1, 2012 Accepting new patients
First Choice Physician Partners Current Accepting new patients
Hospitalists of Modesto Medical Group Inc CurrentSince Jan 1, 2008 Accepting new patients

Locations

1700 McHenry Ave
Ste 65B
Modesto, CA 95350
Phone (209) 581-7063

1541 Florida Ave
Ste 101
Modesto, CA 95350
Phone (209) 575-3839

1541 Florida Ave
Modesto, CA 95350
Phone (209) 214-7049

1441 Florida Ave
Modesto, CA 95350
Phone (209) 214-7235

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": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568592000000",
    "number": "1629133079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7677 OAKPORT ST STE 1200",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946211975",
            "telephone_number": "510-437-4893",
            "fax_number": "510-379-7440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 E 31ST ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946021092",
            "telephone_number": "510-437-4893",
            "fax_number": "510-379-7440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IOCCA",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-26",
        "last_updated": "2019-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "CA",
            "license": "20A6072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.