NPIMap

Organization Active NPI

Thomas K. Stern, M.D. P.C.

  • Family Medicine Physician
  • Berkeley, CA
National Provider Identifier
1730145699
Registry record updated Jun 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G25191 Issued in CA
Legal business name
THOMAS K. STERN, M.D. P.C.
Practice address
3000 Colby Street
Suite 110
Berkeley, CA 94705-0000
Phone
(510) 649-1249
Fax
(510) 649-1345
NPI assigned
Apr 20, 2006
Last updated
Jun 11, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2012

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

Authorized official

Name
Dr. Thomas K. Stern, M.D.
Title
Owner
Phone
(510) 649-1249

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G25191 CA Primary

Addresses

Primary practice location

3000 Colby Street
Suite 110
Berkeley, CA 94705-0000

Mailing address

3000 Colby Street
Suite 110
Berkeley, CA 94705-0000
Phone (510) 649-1249

Other identifiers 1

IdentifierTypeStateIssuer
GR0017760MedicaidCA

National Provider Directory

National Provider Directory

Locations

2636 Telegraph Ave
Berkeley, CA 94704
Phone (510) 841-1647

3000 Colby St
Ste 110
Berkeley, CA 94705
Phone (510) 649-1249

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339372800000",
    "number": "1730145699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 COLBY STREET",
            "address_2": "SUITE 110",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947050000",
            "telephone_number": "510-649-1249",
            "fax_number": "510-649-1345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 COLBY STREET",
            "address_2": "SUITE 110",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947050000",
            "telephone_number": "510-649-1249",
            "fax_number": "510-649-1345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS K. STERN, M.D. P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-20",
        "last_updated": "2012-06-11",
        "status": "A",
        "authorized_official_last_name": "STERN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "510-649-1249",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G25191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0017760",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.