East Bay Nephrology Medical Group, Inc.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

EAST BAY NEPHROLOGY MEDICAL GROUP, INC.

Practice address

2905 Telegraph Ave
Berkeley, CA 94705-2063

Phone

(510) 841-4525

Fax

(510) 848-9970

NPI assigned

Sep 15, 2006

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Thomas A Turner

Title

Chief Operating Officer

Phone

(510) 841-0411

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• East Bay Nephrology Medical Group, Inc

  • Nephrology Physician
  • Oakland, CA
  • NPI 1265527980

  O20040423001160

  Same enrollment
• East Bay Nephrology Medical Group, Inc.

  • Nephrology Physician
  • Vallejo, CA
  • NPI 1184719809

  O20040423001160

  Same enrollment
• East Bay Nephrology Medical Group, Inc.

  • Nephrology Physician
  • San Pablo, CA
  • NPI 1275628992

  O20040423001160

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member organizations 3

Organizations listed as members of this organization in the National Provider Directory.

• Dialysis Access Center a Medical Corporation

  • Nephrology Physician
  • Oakland, CA
  • NPI 1699852327

  Member Of

  NPD member
• Dialysis Access Center a Medical Corporation

  • Ambulatory Surgical Clinic/Center
  • Oakland, CA
  • NPI 1760923445

  Member Of

  NPD member
• Solano Dialysis Access Center, a Professional Corporation.

  • Nephrology Physician
  • Vallejo, CA
  • NPI 1114119500

  Member Of

  NPD member

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 48

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.

• Michael James Ajuria, M.D.

  • Nephrology Physician
  • Berkeley, CA
  • NPI 1922425057
  NPD
• Akosua Appea, FNP

  • Family Nurse Practitioner
  • Berkeley, CA
  • NPI 1669214367
  NPD
• Hardeep Aulakh, AGPCNP-BC

  • Primary Care Nurse Practitioner
  • San Francisco, CA
  • NPI 1508318874
  NPD
• Manasi Bapat, MD

  • Nephrology Physician
  • Walnut Creek, CA
  • NPI 1861834996
  NPD
• John Peter Baron, D.O.

  • Nephrology Physician
  • Travis AFB, CA
  • NPI 1861471591
  NPD
• Jean Claude Bassila, M.D.

  • Nephrology Physician
  • Santa Rosa, CA
  • NPI 1487817854
  NPD
• Seray Hawah Bayoh, FNP-BC

  • Nurse Practitioner
  • Stanford, CA
  • NPI 1437557634
  NPD
• Donald A Block, MD

  • Nephrology Physician
  • Berkeley, CA
  • NPI 1205933934
  NPD
• Evaline Chang, NP

  • Nurse Practitioner
  • Stanford, CA
  • NPI 1831532506
  NPD
• Mario L Corona, MD

  • Nephrology Physician
  • Berkeley, CA
  • NPI 1679670301
  NPD
• Robert B Doud, MD

  • Nephrology Physician
  • Berkeley, CA
  • NPI 1184721821
  NPD
• Claudia I Iota-Herbei

  • Nephrology Physician
  • Berkeley, CA
  • NPI 1548367113
  NPD

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1871699074",
    "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": "510-841-4525",
            "fax_number": "510-848-9970"
        },
        {
            "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": "510-841-4525",
            "fax_number": "510-848-9970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST BAY NEPHROLOGY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-15",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "TURNER",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "510-841-0411"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP #",
            "identifier": "CR0683",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0049640",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dominika Maria Dymarczyk
• Caitlin Ealum
• Aryn L Earnhardt, FNP
• East Bay Acupuncture & Natural Medicine
• East Bay Head & Neck Surgery Medical Group, Inc.
• East Bay Neurosurgery and Spine, a Medical Corporation
• East Bay Primary and Preventive Care Medical Corp
• Ann K. Eastman, MD
• Jazelle Unique Eastman
• Noah Eastman

• Nephrology Physician in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Nephrology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.