Individual provider Active NPI

Mary Jane Diogo, RN, NP, CNM

  • Advanced Practice Midwife
  • Oakland, CA
National Provider Identifier
1952493413
Registry record updated Dec 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
CNM1359 Issued in CA
Practice address
350 30TH St
Suite 205
Oakland, CA 94609-3424
Phone
(510) 271-5339
NPI assigned
Sep 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Perinatal Registered Nurse 163WP1700X RN320362 CA
Nurse Practitioner 363L00000X NP 5855 CA
Advanced Practice Midwife 367A00000X CNM1359 CA Primary

Addresses

Primary practice location

350 30TH St
Suite 205
Oakland, CA 94609-3424

Mailing address

350 30TH St
Suite 205
Oakland, CA 94609-3424
Phone (510) 271-5339

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041130000651 CA Practitioner - Certified Nurse Midwife (CNM) 7113982224 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN320362CAMDPerinatal Registered Nurse
1359CAMDMassage Therapist
NP 5855CAMDNurse Practitioner
CNM1359CAMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc Current Accepting new patients
Permanente Medical Group, Inc CurrentSince Oct 11, 2016 Accepting new patients
Permanente Medical Group Inc CurrentSince Oct 11, 2016 Accepting new patients
Obhg California, P.C. CurrentSince Oct 11, 2016 Accepting new patients
Sutter Community Health Past Accepting new patients
East Bay Perinatal Medical Associates Past Accepting new patients

Locations

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

2450 Ashby Ave
Berkeley, CA 94705
Phone (510) 204-1566

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

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

1800 Harrison St
Fl 7
Oakland, CA 94612

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

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

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

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1952493413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 30TH ST",
            "address_2": "SUITE 205",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093424",
            "telephone_number": "510-271-5339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 30TH ST",
            "address_2": "SUITE 205",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093424",
            "telephone_number": "510-271-5339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIOGO",
        "first_name": "MARY",
        "middle_name": "JANE",
        "credential": "RN, NP, CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-29",
        "last_updated": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP1700X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Perinatal",
            "state": "CA",
            "license": "RN320362",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP 5855",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CA",
            "license": "CNM1359",
            "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": "975 Sereno Dr",
            "city": "Vallejo",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945892441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.