Individual provider Active NPI

Cornelia Moura Pessoa, M.D.

  • Specialist
  • Berkeley, CA
National Provider Identifier
1689757635
Registry record updated Nov 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G60130 Issued in CA
Practice address
2320 Woolsey St
Suite 202
Berkeley, CA 94705-1973
Phone
(510) 486-1700
Fax
(510) 486-1133
NPI assigned
Oct 23, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X G60130 CA Primary

Addresses

Primary practice location

2320 Woolsey St
Suite 202
Berkeley, CA 94705-1973

Mailing address

2320 Woolsey St
Suite 202
Berkeley, CA 94705-1973
Phone (510) 486-1700

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
I20100416000757 CA Practitioner - Dermatology 8426143736 Receives reassigned benefits from 2 practitioners
Practice locations: Berkeley, CA

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cornelia M Pessoa, MD Specialist PastSince Mar 17, 1994 Accepting new patients

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Organizations & group practices 1

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": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383782400000",
    "number": "1689757635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2320 WOOLSEY ST",
            "address_2": "SUITE 202",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947051973",
            "telephone_number": "510-486-1700",
            "fax_number": "510-486-1133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2320 WOOLSEY ST",
            "address_2": "SUITE 202",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947051973",
            "telephone_number": "510-486-1700",
            "fax_number": "510-486-1133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PESSOA",
        "first_name": "CORNELIA",
        "middle_name": "MOURA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2013-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G60130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.