Individual provider Active NPI

Arya Mansouri, M.D.

  • Internal Medicine Physician
  • Oakland, CA
National Provider Identifier
1760802847
Registry record updated Feb 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A172792 Issued in CA
Practice address
350 Hawthorne Ave Ste 2308
Oakland, CA 94609-3108
Phone
(510) 869-6883
Fax
(510) 869-6888
NPI assigned
Apr 16, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X A172792 CA
Internal Medicine Physician 207R00000X A172792 CA Primary

Addresses

Primary practice location

350 Hawthorne Ave Ste 2308
Oakland, CA 94609-3108

Mailing address

325 Distel Cir
Los Altos, CA 94022-1408
Phone (510) 869-6883

Other identifiers 1

IdentifierTypeStateIssuer
A172792OtherCASTATE MEDICAL LICENSE

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
I20210804002184 CA Practitioner - Internal MedicinePractitioner - Hospitalist 5597035188 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

350 Hawthorne Ave
Oakland, CA 94609-3108
Phone (510) 869-6500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A172792CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of California San Francisco Current Accepting new patients
UCSF Medical Group Business Services Internal Medicine CurrentSince Jul 29, 2021 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Feb 1, 2022 Accepting new patients
University of California San Francisco CurrentSince Jul 29, 2021 Accepting new patients
Sutter Bay Medical Foundation Internal Medicine CurrentSince Feb 1, 2022 Accepting new patients
UCSF Medical Group Business Services CurrentSince Jul 29, 2021 Accepting new patients
Sutter Bay Medical Foundation Current Accepting new patients
University of California San Francisco Internal Medicine CurrentSince Jul 29, 2021 Accepting new patients
Regents of the University of California Internal Medicine CurrentSince Jul 29, 2021 Accepting new patients
Alta Bates Summit Medical Center Past Accepting new patients
Sutter East Bay Medical Foundation Past Accepting new patients
Sutter Bay Hospitals Past Accepting new patients

Locations

18400 US Highway 18
Apple Valley, CA 92307
Phone (760) 810-7590

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

350 John Muir Pkwy
Ste 160
Brentwood, CA 94513
Phone (925) 204-1920

1950 University Ave
Ste 160
East Palo Alto, CA 94303
Phone (650) 317-8100

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

1189 E Herndon Ave
Ste 103
Fresno, CA 93720
Phone (559) 450-7777

325 Distel Cir
Los Altos, CA 94022
Phone (510) 204-3977

370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200

600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755

101 Rowland Way
Ste 220
Novato, CA 94945
Phone (415) 878-7200

350 Hawthorne Ave
Oakland, CA 94609
Phone (510) 655-4000

350 Hawthorne Ave
Ste 2308
Oakland, CA 94609
Phone (510) 869-6883

795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832

1555 East St
Ste 200
Redding, CA 96001
Phone (530) 229-0911

151 N Sunrise Ave
Ste 1205
Roseville, CA 95661
Phone (916) 789-1505

3838 California St
Rm 410
San Francisco, CA 94118
Phone (415) 751-1847

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

123 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 343-4200

3883 Airway Dr
Ste 220
Santa Rosa, CA 95403
Phone (707) 521-7750

10200 Trinity Pkwy
Ste 101
Stockton, CA 95219
Phone (209) 323-3488

Interoperability endpoints

  • Direct secure messaging: amansouri608356@hisp.ehr.sutterhealth.org

Organizations & group practices 12

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1397606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644278400000",
    "number": "1760802847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408",
            "telephone_number": "510-869-6883",
            "fax_number": "510-869-6888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 HAWTHORNE AVE STE 2308",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093108",
            "telephone_number": "510-869-6883",
            "fax_number": "510-869-6888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSOURI",
        "first_name": "ARYA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-16",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A172792",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A172792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "A172792",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.