Individual provider Active NPI

Diego Rafael Fernandez, M.D.

  • Internal Medicine Physician
  • Oakland, CA
National Provider Identifier
1871957712
Registry record updated Apr 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A172321 Issued in CA
Practice address
350 Hawthorne Ave Ste 2308
Oakland, CA 94609-3108
Phone
(510) 869-6883
Fax
(510) 869-6888
NPI assigned
Apr 6, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD.36555 AL
Internal Medicine Physician 207R00000X A172321 CA Primary

Addresses

Primary practice location

350 Hawthorne Ave Ste 2308
Oakland, CA 94609-3108

Mailing address

325 Distel Cir
Los Altos, CA 94022-1408
Phone (510) 869-6883

Other identifiers 1

IdentifierTypeStateIssuer
A172321OtherCASTATE MEDICAL LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

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
I20210915003346 CA Practitioner - Internal MedicinePractitioner - Hospitalist 8123315561 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

350 Hawthorne Ave
Oakland, CA 94609-3108
Phone (510) 655-4000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.36555ALMDInternal Medicine Physician
A172321CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc Internal Medicine Current Accepting new patients
Sutter Bay Medical Foundation CurrentSince May 1, 2022 Accepting new patients
Permanente Medical Group, Inc CurrentSince Sep 8, 2021 Accepting new patients
Permanente Medical Group Inc Internal Medicine CurrentSince Sep 8, 2021 Accepting new patients
Sutter Bay Medical Foundation CurrentSince May 1, 2022 Accepting new patients
Sutter East Bay Medical Foundation Past Accepting new patients
Sutter Bay Hospitals Past Accepting new patients
Sutter East Bay Medical Foundation Internal Medicine Past Accepting new patients
Alta Bates Summit Medical Center Past Accepting new patients

Locations (25 of 33)

4501 Sand Creek Rd
Antioch, CA 94531
Phone (925) 813-6420

18400 US Highway 18
Apple Valley, CA 92307
Phone (760) 810-7590

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

350 John Muir Pkwy
Ste 160
Brentwood, CA 94513
Phone (925) 204-1920

1950 University Ave
Ste 160
East Palo Alto, CA 94303
Phone (650) 317-8100

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

1189 E Herndon Ave
Ste 103
Fresno, CA 93720
Phone (559) 450-7777

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200

325 Distel Cir
Los Altos, CA 94022
Phone (510) 204-3977

600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755

101 Rowland Way
Ste 220
Novato, CA 94945
Phone (415) 878-7200

350 Hawthorne Ave
Oakland, CA 94609
Phone (510) 655-4000

350 Hawthorne Ave
Ste 2308
Oakland, CA 94609
Phone (510) 869-6883

795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

1555 East St
Ste 200
Redding, CA 96001
Phone (530) 229-0911

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

151 N Sunrise Ave
Ste 1205
Roseville, CA 95661
Phone (916) 789-1505

501 J St
Sacramento, CA 95814
Phone (916) 497-3000

3838 California St
Rm 410
San Francisco, CA 94118
Phone (415) 751-1847

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

Interoperability endpoints

  • Direct secure messaging: dfernandez616159@hisp.ehr.sutterhealth.org

Organizations & group practices 9

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 2

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": "1459900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649980800000",
    "number": "1871957712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408",
            "telephone_number": "510-869-6883",
            "fax_number": "510-569-6888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 HAWTHORNE AVE STE 2308",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093108",
            "telephone_number": "510-869-6883",
            "fax_number": "510-869-6888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "DIEGO",
        "middle_name": "RAFAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-06",
        "last_updated": "2022-04-15",
        "certification_date": "2022-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "MD.36555",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A172321",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "A172321",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4501 Sand Creek Rd",
            "city": "Antioch",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945318687",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.