Altaf Ansari, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

352047 Issued in CA

Practice address

2500 Milvia St
Berkeley, CA 94704-2636

Phone

(510) 204-5514

Fax

(510) 204-5515

NPI assigned

Jan 17, 2007

Last updated

Aug 10, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 2

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

Specialty

Emergency Medicine

Education

Other, 1976

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: aansari291183@hisp.ehr.sutterhealth.org

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.

• Sutter Bay Medical Foundation

  dba Palo Alto Medial Foundation

  • Multi-Specialty Clinic/Center
  • Palo Alto, CA
  • NPI 1013950807
  Medicare reassignment Care Compare group NPD
• Sutter Bay Medical Foundation

  dba Sutter Pacific Medical Foundation

  • Multi-Specialty Clinic/Center
  • Sacramento, CA
  • NPI 1003267196

  Internal Medicine

  NPD
• Sutter Bay Medical Foundation

  dba Palo Alto Medical Foundation

  • Clinical Medical Laboratory
  • Santa Clara, CA
  • NPI 1669287033
  NPD
• Beth Israel Medical Center

  • Emergency Medicine Physician
  • New York, NY
  • NPI 1740378421
  NPD (past)
• Bimc Faculty Practice

  • Emergency Medicine Physician
  • New York, NY
  • NPI 1538351572
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1700938297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 AIRPORT EXE PARK",
            "city": "NANUET",
            "state": "NY",
            "postal_code": "10954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 MILVIA ST",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947042636",
            "telephone_number": "510-204-5514",
            "fax_number": "510-204-5515"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "330 EAST 17TH ST",
            "address_purpose": "LOCATION",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10003",
            "country_code": "US",
            "telephone_number": "212-420-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4053 Lone Tree Way Ste 101",
            "address_purpose": "LOCATION",
            "city": "Antioch",
            "state": "CA",
            "postal_code": "945316210",
            "country_code": "US",
            "telephone_number": "925-756-3499",
            "fax_number": "510-506-7732",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20101 Lake Chabot Rd",
            "address_purpose": "LOCATION",
            "city": "Castro Valley",
            "state": "CA",
            "postal_code": "945465305",
            "country_code": "US",
            "telephone_number": "510-247-6300",
            "fax_number": "510-247-6303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANSARI",
        "first_name": "ALTAF",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "164300",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "352047",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "352047",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "164300",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01016366",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "C56132",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Liane Angus
• Andrea Neda Anjomshoaa
• Brandon Annabel, NP
• Devora Anner
• Annie Chen Family Therapy Inc
• Anshuja Chowdhary DDS PC (Berkeley Dental Center)
• Ashley Brooke Ante
• Anthony Dailley DDS
• Lindsey Erin Antin, MFT
• Jennifer Antonuccio

• Emergency Medicine Physician in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.