Individual provider Active NPI

Tristan Klosterman, M.D.

  • Otolaryngology Physician
  • Oakland, CA
National Provider Identifier
1871889709
Registry record updated May 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
A152155 Issued in CA
Practice address
1411 E 31St St
Oakland, CA 94602-1018
Phone
(510) 437-4800
NPI assigned
Jun 20, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Otolaryngology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Y00000X A152155 CA Primary

Addresses

Primary practice location

1411 E 31St St
Oakland, CA 94602-1018

Mailing address

1411 E 31St St
Oakland, CA 94602-1092
Phone (510) 437-4800

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171229001637 CA Practitioner - OtolaryngologyPractitioner - Plastic and Reconstructive Surgery 0941581318 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alameda Health SystemGroup PAC ID 3779494521, 597 clinicians

Practice addresses (Care Compare)

13855 E 14TH St
San Leandro, CA 94578-2611
Phone (510) 357-6500

1411 E 31St St
Oakland, CA 94602-1018
Phone (510) 437-4800

Hospital & facility affiliations

  • Highland Hospital Hospital, Oakland, CA, CCN 050320

Merit-based Incentive Payment System (MIPS)

Final score
95.17 of 100Reported as group
Quality
86.93
Promoting interoperability
100
Improvement activities
40
Cost
72.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A152155CAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alameda Health System Multi-Specialty CurrentSince May 31, 2020 Accepting new patients
Alameda Health System Multi-Specialty CurrentSince May 31, 2020 Accepting new patients
Alameda Health System Past Accepting new patients
Lenox Hill Hospital Past Accepting new patients

Locations

664 Southland Mall
Hayward, CA 94545
Phone (510) 266-1700

1411 E 31st St
Oakland, CA 94602
Phone (510) 437-4323

7677 Oakport St
Ste 1200
Oakland, CA 94621
Phone (510) 618-5768

13855 E 14th St
San Leandro, CA 94578
Phone (510) 357-6500

Interoperability endpoints

  • Direct secure messaging: tklosterman14289@alamedahs.direct-ci.com

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1308528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558656000000",
    "number": "1871889709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 E 31ST ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946021092",
            "telephone_number": "510-437-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 E 31ST ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946021018",
            "telephone_number": "510-437-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLOSTERMAN",
        "first_name": "TRISTAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-20",
        "last_updated": "2019-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A152155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.