Organization Active NPI

Island Medical Group a Medical Corporation

  • Nephrology Physician
  • Alameda, CA
National Provider Identifier
1750474045
Registry record updated Jul 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A48009 Issued in CA
Legal business name
ISLAND MEDICAL GROUP A MEDICAL CORPORATION
Practice address
2070 Clinton Ave FL 4
Alameda, CA 94501-4320
Phone
(510) 748-0931
Fax
(510) 748-8110
NPI assigned
Oct 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2021

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

Authorized official

Name
Dr. Alka Sharma, MDNPI 1275737561
Title
MD / Owner
Phone
(510) 748-0931

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X A48009 CA Primary

Addresses

Primary practice location

2070 Clinton Ave FL 4
Alameda, CA 94501-4320

Mailing address

PO Box 1099
Alameda, CA 94501-0499
Phone (510) 748-0931

Other identifiers 1

IdentifierTypeStateIssuer
00A480090MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050111000845 CA Part B Supplier - Clinic/Group Practice 0840248324 Receives reassigned benefits from 1 practitioner
Practice locations: Alameda, CA

National Provider Directory

National Provider Directory

Locations

2070 Clinton Ave
#4
Alameda, CA 94501
Phone (510) 748-0931

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627603200000",
    "number": "1750474045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1099",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945010499",
            "telephone_number": "510-748-0931",
            "fax_number": "510-748-8110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2070 CLINTON AVE FL 4",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945014320",
            "telephone_number": "510-748-0931",
            "fax_number": "510-748-8110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLAND MEDICAL GROUP A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2021-07-30",
        "certification_date": "2021-07-30",
        "status": "A",
        "authorized_official_last_name": "SHARMA",
        "authorized_official_first_name": "ALKA",
        "authorized_official_title_or_position": "MD / OWNER",
        "authorized_official_telephone_number": "510-748-0931",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A48009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A480090",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alameda, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.