Individual provider Active NPI

Elizabeth Ancheta, MD

  • Pediatrics Physician
  • Dublin, CA
National Provider Identifier
1801933775
Registry record updated May 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A88071 Issued in CA
Practice address
4050 Dublin Blvd
Dublin, CA 94568-3112
Phone
(925) 875-6100
Fax
(925) 875-6213
NPI assigned
Jan 31, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A88071 CA Primary

Addresses

Primary practice location

4050 Dublin Blvd
Dublin, CA 94568-3112

Mailing address

325 Distel Cir
Los Altos, CA 94022-1408
Phone (925) 875-6100

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
I20070413000251 CA Practitioner - Pediatric Medicine 2860597283 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A88071CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation CurrentSince Feb 5, 2012 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Feb 5, 2012 Accepting new patients
Sutter East Bay Medical Foundation Past Accepting new patients
Stanford Health Care Tri-Valley Past Accepting new patients

Locations

4050 Dublin Blvd
Dublin, CA 94568
Phone (925) 875-6100

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

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

2350 W El Camino Real
Fl 2
Mountain View, CA 94040
Phone (650) 691-6174

Interoperability endpoints

  • Direct secure messaging: eanchetamd17633@hisp.ehr.sutterhealth.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590451200000",
    "number": "1801933775",
    "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": "925-875-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4050 DUBLIN BLVD",
            "city": "DUBLIN",
            "state": "CA",
            "postal_code": "945683112",
            "telephone_number": "925-875-6100",
            "fax_number": "925-875-6213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANCHETA",
        "first_name": "ELIZABETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2020-05-26",
        "certification_date": "2020-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A88071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, CA

Sources for this page

Verify at the official NPI Registry.