Individual provider Active NPI

Edward V Becker, MD

  • Dermatology Physician
  • Walnut Creek, CA
National Provider Identifier
1962515858
Registry record updated Jul 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
G36892 Issued in CA
Practice address
2255 Ygnacio Valley Rd
#B-1
Walnut Creek, CA 94598
Phone
(925) 945-7005
Fax
(925) 945-7084
NPI assigned
Aug 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X G36892 CA Primary

Addresses

Primary practice location

2255 Ygnacio Valley Rd
#B-1
Walnut Creek, CA 94598

Mailing address

2255 Ygnacio Valley Rd
#B-1
Walnut Creek, CA 94598
Phone (925) 945-7005

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
I20101123001195 CA Practitioner - Dermatology 7911193453 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
99.15 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G36892CAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Golden State Dermatology Associates, Inc. Dermatology CurrentSince Feb 1, 2019 Accepting new patients
Golden State Dermatology Associates, Inc. CurrentSince Feb 1, 2019 Accepting new patients
Encino Derma Surgery Center, Inc. PastSince Apr 17, 2024 Accepting new patients
Moy-Fincher-Chipps Surgery Center, Inc. PastSince Apr 17, 2024 Accepting new patients

Locations

1200 Central Blvd
Ste D
Brentwood, CA 94513
Phone (925) 308-9510

355 Lennon Ln
Ste 255
Walnut Creek, CA 94598
Phone (925) 932-7704

370 N Wiget Ln
Ste 250
Walnut Creek, CA 94598
Phone (925) 278-7592

2255 Ygnacio Valley Rd
Ste B1
Walnut Creek, CA 94598
Phone (925) 945-7005

Organizations & group practices 4

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": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500422400000",
    "number": "1962515858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2255 YGNACIO VALLEY RD",
            "address_2": "#B-1",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "94598",
            "telephone_number": "925-945-7005",
            "fax_number": "925-945-7084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2255 YGNACIO VALLEY RD",
            "address_2": "#B-1",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "94598",
            "telephone_number": "925-945-7005",
            "fax_number": "925-945-7084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKER",
        "first_name": "EDWARD",
        "middle_name": "V",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2017-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "G36892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

Verify at the official NPI Registry.