Individual provider Active NPI

Nadereh Sarnevesht, P.A.

  • Medical Physician Assistant
  • Berkeley, CA
National Provider Identifier
1871689471
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA14477 Issued in CA
Practice address
2905 Telegraph Ave
Berkeley, CA 94705-2063
Phone
(510) 841-0411
Fax
(510) 845-5030
NPI assigned
Oct 4, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA14477 CA Primary

Addresses

Primary practice location

2905 Telegraph Ave
Berkeley, CA 94705-2063

Mailing address

2905 Telegraph Ave
Berkeley, CA 94705-2063
Phone (510) 841-0411

Other identifiers 1

IdentifierTypeStateIssuer
0PA144770MedicaidCA

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
I20080624000456 CA Practitioner - Physician Assistant 8123199890 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2905 Telegraph Ave
Berkeley, CA 94705-2017
Phone (510) 841-0411

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14477CAMDOccupational Therapist
PA14477CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
East Bay Nephrology Medical Group, Inc. Current Accepting new patients
East Bay Nephrology Medical Group, Inc CurrentSince Jul 1, 1998 Accepting new patients
East Bay Nephrology Medical Group, Inc. Past Accepting new patients

Locations

2905 Telegraph Ave
Berkeley, CA 94705
Phone (510) 841-0411

3043 Summit St
Oakland, CA 94609
Phone (510) 451-6840

125 Hospital Dr
Vallejo, CA 94589
Phone (707) 642-7510

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/6134/brand/1/csg/1/fhir/r4
  • Direct secure messaging: nadereh.sarnevesht.1@6134.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1871689471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2905 TELEGRAPH AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052063",
            "telephone_number": "510-841-0411",
            "fax_number": "510-845-5030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2905 TELEGRAPH AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052063",
            "telephone_number": "510-841-0411",
            "fax_number": "510-845-5030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARNEVESHT",
        "first_name": "NADEREH",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA14477",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0PA144770",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.