Individual provider Active NPI

Richard S. Stern, M.D.

  • Cardiovascular Disease Physician
  • San Pablo, CA
National Provider Identifier
1760495337
Registry record updated Apr 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
G36148 Issued in CA
Practice address
2101 Vale Rd
Suite 201
San Pablo, CA 94806-3835
Phone
(510) 233-9300
Fax
(510) 233-9299
NPI assigned
Aug 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X G36148 CA Primary

Addresses

Primary practice location

2101 Vale Rd
Suite 201
San Pablo, CA 94806-3835

Mailing address

1450 Treat Blvd
Ste 300
Walnut Creek, CA 94597-2168

Other identifiers 1

IdentifierTypeStateIssuer
00G361480MedicaidCA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040930001199 CA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 4082683495 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G36148CAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
John Muir Physician Network CurrentSince Dec 14, 2015 Accepting new patients

Locations

2400 Balfour Rd
Ste 120
Brentwood, CA 94513
Phone (925) 308-8112

380 Civic Dr
Ste 100
Pleasant Hill, CA 94523
Phone (925) 284-3840

2101 Vale Rd
Ste 201
San Pablo, CA 94806
Phone (510) 233-9140

2101 Vale Rd
San Pablo, CA 94806
Phone (510) 233-9300

1450 Treat Blvd
Ste 300
Walnut Creek, CA 94597

Interoperability endpoints

  • Direct secure messaging: rstern50286@hisp.ehr.sutterhealth.org

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460592000000",
    "number": "1760495337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 TREAT BLVD",
            "address_2": "STE 300",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945972168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 VALE RD",
            "address_2": "SUITE 201",
            "city": "SAN PABLO",
            "state": "CA",
            "postal_code": "948063835",
            "telephone_number": "510-233-9300",
            "fax_number": "510-233-9299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STERN",
        "first_name": "RICHARD",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2016-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "G36148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G361480",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Pablo, CA

Sources for this page

Verify at the official NPI Registry.