Active NPI
Michael Charles Watung, DNP, FNP-BC
- Family Nurse Practitioner
- Oakland, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 95013395
- Practice address
- 2950 International Blvd
Oakland, CA 94601-2228 - Phone
- (510) 535-4400
- NPI assigned
- Dec 9, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 95013395 | CA | Primary |
Addresses
Primary practice location
2950 International Blvd
Oakland, CA 94601-2228
Mailing address
742 W Highland Ave
San Bernardino, CA 92405-3839
Phone (909) 881-7320
Other practice location 1
11234 Anderson St
Loma Linda, CA 92354-2804
Phone (909) 555-4000
Other practice location 2
742 W Highland Ave
San Bernardino, CA 92405-3839
Phone (909) 881-7320
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95013395 | CA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| City & County of San Francisco | Current | Accepting new patients | |
| City & County of San Francisco | Current | Accepting new patients | |
| Native American Health Center, Inc | Current | Accepting new patients | |
| City and County of San Francisco | Current | Accepting new patients | |
| Native American Health Center, Inc | Current | Accepting new patients | |
| Native American Health Center, Inc | Current | Accepting new patients | |
| California Pacific Medical Group, Inc. | Past | Accepting new patients |
Locations
3124 International Blvd
#2D
Oakland, CA 94601
2950 International Blvd
Oakland, CA 94601
Phone (510) 485-5948
160 Capp St
San Francisco, CA 94110
Phone (415) 417-3500
1001 Potrero Ave
San Francisco, CA 94110
Phone (415) 206-2305
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- michael.watung.p1@direct.metro.nextgenshare.com
Organizations & group practices 7
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.
-
- Clinical Medical Laboratory
- San Francisco, CA
- NPI 1982737524
-
- Federally Qualified Health Center (FQHC)
- San Francisco, CA
- NPI 1669642914
-
- Community Health/Public Health Clinical Nurse Specialist
- San Francisco, CA
- NPI 1609041060
-
- Methadone Clinic
- San Francisco, CA
- NPI 1578787925
-
- Federally Qualified Health Center (FQHC)
- Oakland, CA
- NPI 1477250504
-
- Federally Qualified Health Center (FQHC)
- Oakland, CA
- NPI 1619147030
-
- Multi-Specialty Clinic/Center
- Oakland, CA
- NPI 1275002453
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1575849600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637280000000",
"number": "1780221796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "742 W HIGHLAND AVE",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924053839",
"telephone_number": "909-881-7320"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2950 INTERNATIONAL BLVD",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946012228",
"telephone_number": "510-535-4400"
}
],
"practiceLocations": [
{
"address_1": "11234 Anderson St",
"address_purpose": "LOCATION",
"city": "Loma Linda",
"state": "CA",
"postal_code": "923542804",
"country_code": "US",
"telephone_number": "909-555-4000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "742 W Highland Ave",
"address_purpose": "LOCATION",
"city": "San Bernardino",
"state": "CA",
"postal_code": "924053839",
"country_code": "US",
"telephone_number": "909-881-7320",
"fax_number": "909-881-7330",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WATUNG",
"first_name": "MICHAEL",
"middle_name": "CHARLES",
"credential": "DNP, FNP-BC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-12-09",
"last_updated": "2021-11-19",
"certification_date": "2021-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "95013395",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.