Individual provider Active NPI

Barry A. Waldman, MD

  • Dermatology Physician
  • Martinez, CA
National Provider Identifier
1760560825
Registry record updated Dec 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
G68109 Issued in CA
Practice address
200 Muir Rd
Martinez, CA 94553-4614
Phone
(925) 372-1000
NPI assigned
Nov 2, 2006
Last updated
Dec 3, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X G68109 CA Primary

Addresses

Primary practice location

200 Muir Rd
Martinez, CA 94553-4614

Mailing address

1800 Harrison St FL 7
Oakland, CA 94612-3466
Phone (510) 625-6262

Other identifiers 1

IdentifierTypeStateIssuer
00G681090MedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

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
I20091023000589 CA Practitioner - Dermatology 5193862118 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Harvard Medical School, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jerome R Potozkin MD, a Professional CorporationGroup PAC ID 4981893146, 7 clinicians

Practice addresses (Care Compare)

600 San Ramon Valley Blvd
Danville, CA 94526-4021
Phone (925) 838-4900

Merit-based Incentive Payment System (MIPS)

Final score
92.01 of 100Reported as group
Quality
93.81
Improvement activities
40
Cost
81.62

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision12
Removal of skin lesions342
Skin biopsy183

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G68109CAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc Dermatology Current Accepting new patients
Jerome R Potozkin MD, a Professional Corporation Dermatology CurrentSince Jan 1, 2023 Accepting new patients
Permanente Medical Group, Inc CurrentSince Aug 24, 2009 Accepting new patients
Permanente Medical Group Inc Dermatology CurrentSince Aug 24, 2009 Accepting new patients

Locations

600 San Ramon Valley Blvd
Ste 102
Danville, CA 94526
Phone (925) 385-8980

200 Muir Rd
Martinez, CA 94553
Phone (925) 313-4600

1800 Harrison St
Fl 7
Oakland, CA 94612

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

Organizations & group practices 4

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": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638489600000",
    "number": "1760560825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 HARRISON ST FL 7",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946123466",
            "telephone_number": "510-625-6262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MUIR RD",
            "city": "MARTINEZ",
            "state": "CA",
            "postal_code": "945534614",
            "telephone_number": "925-372-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDMAN",
        "first_name": "BARRY",
        "middle_name": "A.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2021-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "G68109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G681090",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "200 Muir Rd",
            "city": "Martinez",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945534614",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Martinez, CA

Sources for this page

Verify at the official NPI Registry.