NPIMap

Individual provider Active NPI

Maria Enrica Diaz Pagtalunan, MD

  • Nephrology Physician
  • Berkeley, CA
National Provider Identifier
1629175310
Registry record updated May 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A48370 Issued in CA
Practice address
2905 Telegraph Ave
Berkeley, CA 94705-2017
Phone
(510) 841-4525
Fax
(510) 204-9086
NPI assigned
Sep 17, 2006
Last updated
May 29, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X A48370 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

Other identifiers 2

IdentifierTypeStateIssuer
390003257OtherCARAILROAD MEDICARE
00A483700MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080117000402 CA Practitioner - NephrologyPractitioner - Internal Medicine 5294742391 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

125 Hospital Dr
Vallejo, CA 94589-2562
Phone (707) 642-7510

2089 Vale Rd
Suite 32
San Pablo, CA 94806-3850
Phone (510) 235-1057

2905 Telegraph Ave
Berkeley, CA 94705-2017
Phone (510) 841-0411

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A48370CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East Bay Nephrology Medical Group, Inc. Nephrology Current Accepting new patients
Dialysis Access Center a Medical Corporation Nephrology CurrentSince Jun 1, 2003 Accepting new patients
East Bay Nephrology Medical Group, Inc. Nephrology CurrentSince Jan 16, 1995 Accepting new patients
Alta Bates Summit Medical Center Past Accepting new patients
Emanate Health Medical Center Past Accepting new patients
Sutter Bay Hospitals Past Accepting new patients
East Bay Nephrology Medical Group, Inc Nephrology Past Accepting new patients
California Pacific Medical Group, Inc. Past Accepting new patients
East Bay Nephrology Medical Group, Inc. Nephrology Past Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
Alameda Health System Past Accepting new patients
Ringwood Dialysis LLC PastSince Jan 24, 2024 Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients
Hill Physicians Medical Group - PPO Program Past Accepting new patients

Locations

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

14400 Olympic Dr
Clearlake, CA 95422
Phone (707) 253-7005

3443 Villa Ln
Ste 6
Napa, CA 94558
Phone (707) 252-8407

3012 Summit St
#D
Oakland, CA 94609
Phone (510) 251-1002

3043 Summit St
Oakland, CA 94609
Phone (510) 451-6840

350 30th St
Ste 311
Oakland, CA 94609
Phone (510) 465-0941

14020 San Pablo Ave
Ste A
San Pablo, CA 94806
Phone (510) 235-1057

2089 Vale Rd
Ste 32
San Pablo, CA 94806
Phone (510) 232-0892

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

127 Hospital Dr
Ste 102
Vallejo, CA 94589
Phone (707) 643-9010

127 Hospital Dr
Ste 204
Vallejo, CA 94589
Phone (707) 642-7510

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/6134/brand/1/csg/1/fhir/r4
  • Direct secure messaging: maria.pagtalunan.1@6134.direct.athenahealth.com
  • Direct secure messaging: mpagtalunan161387@hisp.ehr.sutterhealth.org

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 9

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": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432857600000",
    "number": "1629175310",
    "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": "510-204-9086"
        },
        {
            "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": "510-204-9086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAGTALUNAN",
        "first_name": "MARIA",
        "middle_name": "ENRICA DIAZ",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-17",
        "last_updated": "2015-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A48370",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "390003257",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A483700",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.