Organization Active NPI

Sutter East Bay Medical Foundation

  • Family Medicine Physician
  • Orinda, CA
National Provider Identifier
1871538769
Registry record updated Oct 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SUTTER EAST BAY MEDICAL FOUNDATION
Practice address
12 Camino Encinas
Orinda, CA 94563-3304
Phone
(510) 204-8180
NPI assigned
Jun 17, 2006
Last updated
Oct 11, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2012

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

Authorized official

Name
Cathy Prosser
Title
Director Patient Financial Services
Phone
(925) 962-6616

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X
Family Medicine Physician 207Q00000X Primary
Internal Medicine Physician 207R00000X
Cardiovascular Disease Physician 207RC0000X
Rheumatology Physician 207RR0500X
Obstetrics & Gynecology Physician 207V00000X
Neurology Physician 2084N0400X
Diagnostic Radiology Physician 2085R0202X
Podiatrist 213E00000X
Foot & Ankle Surgery Podiatrist 213ES0103X
Foot Surgery Podiatrist 213ES0131X

Addresses

Primary practice location

12 Camino Encinas
Orinda, CA 94563-3304

Mailing address

PO Box 254869
Sacramento, CA 95865-4869
Phone (916) 854-6795

Other identifiers 2

IdentifierTypeStateIssuer
DE0013OtherCARAILROAD MEDICARE
ZZZ663902OtherCABLUE SHIELD

National Provider Directory

National Provider Directory

Locations

20101 Lake Chabot Rd
Castro Valley, CA 94546
Phone (510) 247-6300

4000 Dublin Blvd
Ste 320
Dublin, CA 94568
Phone (510) 204-2900

Practitioners & affiliated clinicians

Practitioners 3,358

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.

View all 3,358

NPI Registry JSON

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349913600000",
    "number": "1871538769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 254869",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958654869",
            "telephone_number": "916-854-6795",
            "fax_number": "916-854-6739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 CAMINO ENCINAS",
            "city": "ORINDA",
            "state": "CA",
            "postal_code": "945633304",
            "telephone_number": "510-204-8180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUTTER EAST BAY MEDICAL FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-17",
        "last_updated": "2012-10-11",
        "status": "A",
        "authorized_official_last_name": "PROSSER",
        "authorized_official_first_name": "CATHY",
        "authorized_official_title_or_position": "DIRECTOR PATIENT FINANCIAL SERVICES",
        "authorized_official_telephone_number": "925-962-6616"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DE0013",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ663902",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orinda, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.