Jodi Moonbeam Oldfather, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

4160 Issued in CA

Practice address

280 W Macarthur Blvd
Oakland, CA 94611-5642

Phone

(510) 752-1000

NPI assigned

Jan 31, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA, HI3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Jodi Oldfather, Crna LLC

  • Ambulatory Surgical Clinic/Center
  • Hilo, HI
  • NPI 1063307080
  Medicare reassignment NPD Authorized official
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299
  Medicare reassignment NPD
• Assurant Anesthesia Associates Inc

  • Anesthesiology Physician
  • Kailua Kona, HI
  • NPI 1972215358
  Medicare reassignment NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD

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

{
    "created_epoch": "1327968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1942572409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 W MACARTHUR BLVD",
            "address_2": "DEPARTMENT OF ANESTHESIA",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946115642",
            "telephone_number": "510-752-6238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 W MACARTHUR BLVD",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946115642",
            "telephone_number": "510-752-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLDFATHER",
        "first_name": "JODI",
        "middle_name": "MOONBEAM",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-31",
        "last_updated": "2022-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "4160",
            "primary": true
        }
    ],
    "identifiers": [],
    "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": "275 W MacArthur Blvd",
            "city": "Oakland",
            "state": "CA",
            "country_code": "US",
            "postal_code": "946115641",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amenaghawon Okwuegbe
• Oludayo Oluwakemi Oladipo, FNP
• Ikeoluwa Adesiyan Oladoja
• Maleek Oladunjoye I
• Christina Rosario Olague, AMFT
• Destiny Nicole Olgin
• Jennifer Giselle Olguin
• Selena M Olguin
• Diana Olinger
• Paul Michael Oliphant

• Certified Registered Nurse Anesthetist in Oakland, CA
• Providers in Oakland, CA by specialty
• Certified Registered Nurse Anesthetist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.