Individual provider Active NPI

Rebecca Hummel-Moore, N.P.

  • Family Nurse Practitioner
  • Berkeley, CA
National Provider Identifier
1740611375
Registry record updated Dec 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
23453 Issued in CA
Practice address
2001 Dwight Way
Berkeley, CA 94704-2608
Phone
(510) 204-4404
NPI assigned
Dec 8, 2013
Last updated
Dec 8, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 23453 CA Primary

Addresses

Primary practice location

2001 Dwight Way
Berkeley, CA 94704-2608

Mailing address

2713 Grant St
Berkeley, CA 94703-2101
Phone (510) 928-4611

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211020003259 CA Practitioner - Nurse Practitioner 9436470572 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Hospitals CurrentSince Sep 1, 2021 Accepting new patients
Sutter Bay Hospitals CurrentSince Sep 1, 2021 Accepting new patients
Sutter Bay Hospitals Current Accepting new patients

Locations

2001 Dwight Way
Berkeley, CA 94704
Phone (510) 204-1880

2450 Ashby Ave
Berkeley, CA 94705
Phone (510) 204-1566

14207 E 14th St
San Leandro, CA 94578
Phone (510) 220-9578

Interoperability endpoints

  • Direct secure messaging: rhummelmoore156645@hisp.ehr.sutterhealth.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1386460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386460800000",
    "number": "1740611375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2713 GRANT ST",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947032101",
            "telephone_number": "510-928-4611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 DWIGHT WAY",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947042608",
            "telephone_number": "510-204-4404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMMEL-MOORE",
        "first_name": "REBECCA",
        "name_prefix": "Ms.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-08",
        "last_updated": "2013-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "23453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.