NPIMap

Individual provider Active NPI

Tyrone Emanuel Snipes, D.O.

  • Internal Medicine Physician
  • San Leandro, CA
National Provider Identifier
1861627457
Registry record updated Aug 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A10638 Issued in CA
Practice address
3055 Alvarado St
Ste 108
San Leandro, CA 94577-5711
Phone
(510) 969-4253
NPI assigned
May 26, 2009
Last updated
Aug 28, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 20A10638 CA Primary

Addresses

Primary practice location

3055 Alvarado St
Ste 108
San Leandro, CA 94577-5711

Mailing address

3055 Alvarado St
Ste 108
San Leandro, CA 94577-5711
Phone (510) 969-4253

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110715000064 CA Practitioner - Internal Medicine 2466620554 Reassigns benefits to 4 organizations
Practice locations: Oakland, CA

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifelong Medical CareGroup PAC ID 2062304538, shared by 12 NPIs, 75 clinicians

Practice addresses (Care Compare)

3260 Sacramento St
Berkeley, CA 94702-2739
Phone (510) 428-4500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
19.53 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
65.11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A10638CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
KND Development 59, LLC CurrentSince Jan 13, 2013 Accepting new patients
Quantum Healthcare Medical Associates Inc. Internal Medicine CurrentSince Nov 7, 2017 Accepting new patients
KND Development 59 LLC Current Accepting new patients
Inpatient Consultants of California, Inc. Internal Medicine CurrentSince Jul 1, 2011 Accepting new patients
Tyrone E Snipes D O Internal Medicine Primary Care Inc Internal Medicine CurrentSince Jan 4, 2021 Accepting new patients
KND Development 59, LLC CurrentSince Jan 13, 2013 Accepting new patients
Alta Bates Summit Medical Center Past Accepting new patients
California Pacific Medical Group, Inc. Past Accepting new patients
Healthflex Hospice PastSince Oct 1, 2018 Accepting new patients
Hayward Sisters Hospital Past Accepting new patients

Locations

1652 Mono Ave
Ashland, CA 94578
Phone (510) 357-5351

400 N Pepper Ave
Colton, CA 92324
Phone (909) 580-1800

550 N Monterey Ave
Ontario, CA 91764
Phone (909) 629-2290

2800 Benedict Dr
San Leandro, CA 94577
Phone (510) 357-8300

3055 Alvarado St
Ste 108
San Leandro, CA 94577
Phone 5104449460321

3055 Alvarado St
Ste 136
San Leandro, CA 94577
Phone (510) 444-9460

13484 San Pablo Ave
San Pablo, CA 94806
Phone (510) 232-5945

2000 Vale Rd
San Pablo, CA 94806
Phone (510) 235-7000

300 Hospital Dr
Vallejo, CA 94589
Phone (707) 554-4107

7391 W Charleston Blvd
Ste 140
Las Vegas, NV 89117
Phone (702) 233-0684

Ownership & related parties

All facility ownership & control disclosures 9

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ashby Care CenterBerkeley, CA, CCN 555466 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jun 1, 2012
Jun 1, 2012
The Rehabilitation Center of OaklandOakland, CA, CCN 555313 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 May 15, 2024
May 15, 2024
Eden Healthcare CenterHayward, CA, CCN 056052 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Nov 3, 2023
Nov 3, 2023
Bristol Hospice - East BayPleasanton, CA, CCN 921543 Hospice Contracted Managing Employee Nov 1, 2020
MD Choice Hospice IncConcord, CA, CCN 921512 Hospice Contracted Managing Employee May 6, 2019
Healthflex HospiceOakland, CA, CCN A01646 Hospice Contracted Managing Employee Oct 1, 2018
Crossroads Hospice VallejoVallejo, CA, CCN 751700 Hospice Contracted Managing Employee Oct 5, 2020
Ardent Hospice Services IncHayward, CA, CCN A11557 Hospice Contracted Managing Employee Jan 1, 2024
Pinnacle Home Health & Hospice IncSacramento, CA, CCN A11739 Hospice W-2 Managing Employee Mar 11, 2025

Owned or controlled facilities with NPI records 9

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1243296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598572800000",
    "number": "1861627457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3055 ALVARADO ST",
            "address_2": "STE 108",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945775711",
            "telephone_number": "510-969-4253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3055 ALVARADO ST",
            "address_2": "STE 108",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945775711",
            "telephone_number": "510-969-4253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNIPES",
        "first_name": "TYRONE",
        "middle_name": "EMANUEL",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-26",
        "last_updated": "2020-08-28",
        "certification_date": "2020-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A10638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Leandro, CA

Sources for this page

Verify at the official NPI Registry.