NPIMap

Organization Active NPI

Primary Care at Home, Inc.

  • Multi-Specialty Clinic/Center
  • Oakland, CA
National Provider Identifier
1962852939
Registry record updated Jun 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
PRIMARY CARE AT HOME, INC.
Practice address
400 29TH St
Suite 306
Oakland, CA 94609-3522
Phone
(510) 610-0748
NPI assigned
Jun 21, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2016

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

Authorized official

Name
Anthony E Jones, M.D.NPI 1538246194
Title
Chair
Phone
(510) 610-0748

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X CA Primary

Addresses

Primary practice location

400 29TH St
Suite 306
Oakland, CA 94609-3522

Mailing address

400 29TH St
Suite 306
Oakland, CA 94609-3522
Phone (510) 610-0748

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20191030002345 CA Part B Supplier - Clinic/Group Practice 3870825508 Receives reassigned benefits from 4 practitioners
Practice locations: Oakland, CA
O20230511001822 WA Part B Supplier - Clinic/Group Practice 3870825508 Receives reassigned benefits from 1 practitioner
Practice locations: Olympia, WA

National Provider Directory

National Provider Directory

Locations

400 29th St
Ste 306
Oakland, CA 94609
Phone (510) 208-3224

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1466467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466467200000",
    "number": "1962852939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 29TH ST",
            "address_2": "SUITE 306",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093522",
            "telephone_number": "510-610-0748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 29TH ST",
            "address_2": "SUITE 306",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093522",
            "telephone_number": "510-610-0748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE AT HOME, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-21",
        "last_updated": "2016-06-21",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CHAIR",
        "authorized_official_telephone_number": "510-610-0748",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.