Tadios A. Amare, MD
Individual provider Active NPI Hospitalist Physician · Vallejo, CA
NPI 1942374541 · NPPES record last updated Dec 1, 2021
Key facts
- NPI
- 1942374541
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Hospitalist Physician 208M00000X
- License
- G74700 (CA)
- Practice address
- 975 Sereno Dr
Vallejo, CA 94589-2441 - Phone
- (707) 651-1000
- NPI assigned
- Nov 17, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101207000871 | CA | Practitioner - Internal Medicine | 9133316821 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G74700 | CA | MD | Hospitalist Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Permanente Medical Group Inc | Current | Accepting new patients | |
| Permanente Medical Group, Inc | Current |
Accepting new patients | |
| Permanente Medical Group Inc | Current |
Accepting new patients |
Locations
1800 Harrison St
Fl 7
Oakland, CA 94612
1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015
901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500
2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000
710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400
7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000
1 Quality Dr
Vacaville, CA 95688
Phone (707) 453-5000
975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | G74700 | CA | Yes |
Addresses
Primary practice location
975 Sereno Dr
Vallejo, CA 94589-2441
Mailing address
1800 Harrison St FL 7
Oakland, CA 94612-3466
Phone (510) 625-6262
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G747000 | Medicaid | CA |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq | Health Information Exchange (HIE) | The Permanente Medical Group |
Other providers in Vallejo, CA
- Maria Alvarado
- Heydi Nayeli Alvarenga Murillo
- Harriet Alvarez
- Maria Lourdes Nacpil Alvarez
- Vanessa Alvarez
- Lee Michael Amari
- Daisy Mireya Amaya
- Ambulette Services of Northern California
- American Housing, Inc.
- Tziporah Amgott-Kwan
All providers in Vallejo, CA · Hospitalist Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 1, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.