Individual provider Active NPI

Terry M Maher, MD

  • Nephrology Physician
  • Berkeley, CA
National Provider Identifier
1972600229
Registry record updated Mar 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
G39018 Issued in CA
Practice address
2905 Telegraph Ave
Berkeley, CA 94705-2063
Phone
(510) 841-4525
Fax
(510) 848-9970
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X G39018 CA Primary

Addresses

Primary practice location

2905 Telegraph Ave
Berkeley, CA 94705-2063

Mailing address

2905 Telegraph Ave
Berkeley, CA 94705-2063
Phone (510) 841-4525

Other identifiers 2

IdentifierTypeStateIssuer
00G390180MedicaidCA
110073234OtherCARAILROAD MEDICARE

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
I20080624000235 CA Practitioner - NephrologyPractitioner - Internal Medicine 7315965829 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G39018CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East Bay Nephrology Medical Group, Inc. Nephrology CurrentSince May 2, 1983 Accepting new patients
East Bay Nephrology Medical Group, Inc Nephrology CurrentSince May 2, 1983 Accepting new patients
East Bay Nephrology Medical Group, Inc. Nephrology Current Accepting new patients

Locations

2905 Telegraph Ave
Berkeley, CA 94705
Phone (510) 841-0411

10690 San Pablo Ave
El Cerrito, CA 94530
Phone (510) 528-9590

3043 Summit St
Oakland, CA 94609
Phone (510) 451-6840

14020 San Pablo Ave
Ste A
San Pablo, CA 94806
Phone (510) 235-1057

125 Hospital Dr
Vallejo, CA 94589
Phone (707) 642-7510

127 Hospital Dr
Ste 204
Vallejo, CA 94589
Phone (707) 642-7510

Interoperability endpoints

  • Direct secure messaging: tmaher37189@hisp.ehr.sutterhealth.org
  • FHIR API: https://api.platform.athenahealth.com/6134/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489104000000",
    "number": "1972600229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2905 TELEGRAPH AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052063",
            "telephone_number": "510-841-4525",
            "fax_number": "510-848-9970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2905 TELEGRAPH AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052063",
            "telephone_number": "510-841-4525",
            "fax_number": "510-848-9970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHER",
        "first_name": "TERRY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2017-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "G39018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G390180",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110073234",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.