Individual provider Active NPI

Samara S. Nebenzahl, MD

  • Family Medicine Physician
  • Berkeley, CA
National Provider Identifier
1932469889
Registry record updated May 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A128601 Issued in CA
Practice address
2500 Milvia St
Berkeley, CA 94704-2636
Phone
(510) 204-5600
NPI assigned
May 25, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A128601 CA Primary

Addresses

Primary practice location

2500 Milvia St
Berkeley, CA 94704-2636

Mailing address

3687 Mt. Diablo Blvd.
Suite 200
Lafayette, CA 94549-3746

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
I20150723008727 CA Practitioner - Family Practice 5799098448 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Rush Medical College of Rush University, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

20101 Lake Chabot Rd
Castro Valley, CA 94546-5305
Phone (510) 886-3400

20103 Lake Chabot Rd
Castro Valley, CA 94546-5305
Phone (510) 727-3256

2500 Milvia St
Berkeley, CA 94704-2636
Phone (510) 204-5600

3100 Telegraph Ave
Oakland, CA 94609-3239
Phone (510) 204-8290

3200 Kearney St
Fremont, CA 94538-2299
Phone (510) 490-1222

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
128601CAMDMarriage & Family Therapist
A128601CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation CurrentSince Aug 1, 2017 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Aug 1, 2017 Accepting new patients

Locations

2500 Milvia St
Berkeley, CA 94704
Phone (510) 204-5514

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

3687 Mt Diablo Blvd
Ste 200
Lafayette, CA 94549
Phone (510) 204-6660

Interoperability endpoints

  • Direct secure messaging: snebenzahl287216@hisp.ehr.sutterhealth.org

Organizations & group practices 2

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 5

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": "1337904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463529600000",
    "number": "1932469889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3687 MT. DIABLO BLVD.",
            "address_2": "SUITE 200",
            "city": "LAFAYETTE",
            "state": "CA",
            "postal_code": "945493746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 MILVIA ST",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947042636",
            "telephone_number": "510-204-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEBENZAHL",
        "first_name": "SAMARA",
        "middle_name": "S.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-25",
        "last_updated": "2016-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A128601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.