Individual provider Active NPI

Britta Charlene Nelson, PA

  • Physician Assistant
  • Oakland, CA
National Provider Identifier
1831167360
Registry record updated Jan 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA 18211 Issued in CA
Practice address
616 16TH St
Oakland, CA 94612-1205
Phone
(510) 517-3687
NPI assigned
Mar 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA 18211 CA Primary

Addresses

Primary practice location

616 16TH St
Oakland, CA 94612-1205

Mailing address

616 16TH St
Oakland, CA 94612-1205
Phone (510) 517-3687

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170814002994 CA Practitioner - Physician Assistant 1254598758 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
May accept Medicare assignment
Group practices
City of FremontGroup PAC ID 5991880007, 4 clinicians

Practice addresses (Care Compare)

3300 Capitol Ave
Fremont, CA 94538-1514
Phone (510) 574-2050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA 18211CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lifelong Medical Care CurrentSince Apr 10, 2020 Accepting new patients
Lifelong Medical Care CurrentSince Apr 10, 2020 Accepting new patients

Locations

2344 6th St
Berkeley, CA 94710
Phone (510) 981-3203

10700 MacArthur Blvd
Ste 14B
Oakland, CA 94605
Phone (510) 563-4300

616 16th St
Oakland, CA 94612
Phone (510) 451-1273

Organizations & group practices 3

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": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326326400000",
    "number": "1831167360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 16TH ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946121205",
            "telephone_number": "510-517-3687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 16TH ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946121205",
            "telephone_number": "510-517-3687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "BRITTA",
        "middle_name": "CHARLENE",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-10",
        "last_updated": "2012-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA 18211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.