Organization Active NPI

Cornerstone Integrative Medicine

  • Internal Medicine Physician
  • Oakland, CA
National Provider Identifier
1881249332
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CORNERSTONE INTEGRATIVE MEDICINE
Practice address
3012 Summit St Ste 2675
Oakland, CA 94609-3480
Phone
(510) 869-6740
Fax
(510) 869-6742
NPI assigned
Aug 1, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2026

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

Authorized official

Name
Amy Li MateckiNPI 1770571077
Title
Ceo Partner, Co-Owner
Phone
(510) 869-6740

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

3012 Summit St Ste 2675
Oakland, CA 94609-3480

Mailing address

3012 Summit St Ste 2675
Oakland, CA 94609-3480
Phone (510) 326-4649

Other identifiers 10

IdentifierTypeStateIssuer
1346573094MedicaidCA
1790937506MedicaidCA
1932538121MedicaidCA
1831124080MedicaidCA
1861427684MedicaidCA
1770571077MedicaidCA
1245404607MedicaidTN
1558678201MedicaidCA
1003114463MedicaidCA
1295995256MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200831000722 CA Part B Supplier - Clinic/Group Practice 5193142537 Receives reassigned benefits from 1 practitioner
Practice locations: Oakland, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1564617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786492800000",
    "number": "1881249332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3012 SUMMIT ST STE 2675",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093480",
            "telephone_number": "510-326-4649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3012 SUMMIT ST STE 2675",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093480",
            "telephone_number": "510-869-6740",
            "fax_number": "510-869-6742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE INTEGRATIVE MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-01",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A",
        "authorized_official_last_name": "MATECKI",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "LI",
        "authorized_official_title_or_position": "CEO PARTNER, CO-OWNER",
        "authorized_official_telephone_number": "510-869-6740"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1346573094",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790937506",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1932538121",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1831124080",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1861427684",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1770571077",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1245404607",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1558678201",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003114463",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1295995256",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.