Organization Active NPI

Irina V Kolomey D O

  • Internal Medicine Physician
  • Walnut Creek, CA
National Provider Identifier
1821779851
Registry record updated Sep 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
IRINA V KOLOMEY D O
Practice address
1808 San Miguel Dr
Walnut Creek, CA 94596-8606
Phone
(925) 528-2663
NPI assigned
Jul 31, 2023
Last updated
Sep 14, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2023

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

Authorized official

Name
Irina Victor Kolomey, DONPI 1104062173
Title
President
Phone
(925) 363-3395

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

1808 San Miguel Dr
Walnut Creek, CA 94596-8606

Mailing address

1808 San Miguel Dr
Walnut Creek, CA 94596-8606
Phone (925) 363-3395

Other practice location 1

2350 Country Hills Dr Ste B
Antioch, CA 94509-7436
Phone (925) 528-2663

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231115002077 CA Part B Supplier - Clinic/Group Practice 9436506250 Receives reassigned benefits from 1 practitioner
Practice locations: Antioch, CA; Walnut Creek, CA

National Provider Directory

National Provider Directory

Locations

2350 Country Hills Dr
Antioch, CA 94509
Phone (925) 363-3395

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HHFCDD

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1690761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694649600000",
    "number": "1821779851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1808 SAN MIGUEL DR",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945968606",
            "telephone_number": "925-363-3395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1808 SAN MIGUEL DR",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945968606",
            "telephone_number": "925-528-2663"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2350 Country Hills Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "Antioch",
            "state": "CA",
            "postal_code": "945097436",
            "country_code": "US",
            "telephone_number": "925-528-2663",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "IRINA V KOLOMEY D O",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-31",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A",
        "authorized_official_last_name": "KOLOMEY",
        "authorized_official_first_name": "IRINA",
        "authorized_official_middle_name": "VICTOR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "925-363-3395",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.