Alfred Coleman Jr., PAC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

PA10187 Issued in CA

Practice address

1644 Alum Rock Ave
San Jose, CA 95116-2429

Phone

(408) 347-1680

Fax

(408) 347-1681

NPI assigned

Oct 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Meridian Medical Group Professional Corp

  • General Practice Physician
  • San Jose, CA
  • NPI 1457439572
  Medicare reassignment

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720171598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "838 ANTERO CT",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951331202",
            "telephone_number": "408-347-1680",
            "fax_number": "408-347-1681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1644 ALUM ROCK AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951162429",
            "telephone_number": "408-347-1680",
            "fax_number": "408-347-1681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "ALFRED",
        "name_suffix": "Jr.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "PA10187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASSISTANT LICEN",
            "identifier": "PA10187",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heather A Colbert, M.D., PH.D.
• Gregory O Colburn, MD
• Carrie Cole
• Sondra Cole
• Troy Lee Cole, B.A.
• Allison Nicole Coleman
• Angiela Coleman
• Asia Imani Coleman
• Belinda Echevarria Coleman, LCSW
• Erin M Coleman, ATC

• General Practice Physician in San Jose, CA
• Providers in San Jose, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.