Individual provider Active NPI

Charlotte Hull, D.O.

  • Emergency Medicine Physician
  • Antioch, CA
National Provider Identifier
1972958627
Registry record updated Jul 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
20A17162 Issued in CA
Practice address
3901 Lone Tree Way
Antioch, CA 94509
Phone
(925) 779-7200
NPI assigned
May 2, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 20A17162 CA Primary

Addresses

Primary practice location

3901 Lone Tree Way
Antioch, CA 94509

Mailing address

2100 Powell St Ste 400
Emeryville, CA 94608-1826
Phone (510) 350-2600

Other practice location 1

3635 Vista Ave
Saint Louis, MO 63110-2539
Phone (512) 348-1311

Other practice location 2

3635 Vista Ave
Saint Louis, MO 63110-2539
Phone (512) 348-1311

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
I20190815003572 CA Practitioner - Emergency Medicine 5496049983 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - CaliforniaGroup PAC ID 6103739131, shared by 2 NPIs, 1,278 clinicians

Practice addresses (Care Compare)

180 Rowland Way
Novato, CA 94945-5009
Phone (415) 209-1300

Hospital & facility affiliations

  • Novato Community Hospital Hospital, Novato, CA, CCN 050131
  • UCSF Health St. Mary'S Hospital Hospital, San Francisco, CA, CCN 050457
  • UCSF Health Saint Francis Hospital Hospital, San Francisco, CA, CCN 050152
  • San Mateo Medical Center Hospital, San Mateo, CA, CCN 050113

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A17162CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California Emergency Medicine Current Accepting new patients
Cep America-California Emergency Medicine CurrentSince Jun 16, 2019 Accepting new patients
Cep America - California Emergency Medicine CurrentSince Apr 27, 2022 Accepting new patients
Cep America - California Emergency Medicine CurrentSince Jun 16, 2019 Accepting new patients
Cep America - California Emergency Medicine Current Accepting new patients

Locations

3901 Lone Tree Way
Antioch, CA 94509
Phone (925) 779-7200

2755 Herndon Ave
Clovis, CA 93611
Phone (559) 323-4000

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

250 Bon Air Rd
Kentfield, CA 94904
Phone (415) 464-1350

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

180 Rowland Way
Novato, CA 94945
Phone (415) 209-1300

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

15031 Rinaldi St
San Fernando, CA 91345
Phone (818) 365-8051

900 Hyde St
San Francisco, CA 94109
Phone (415) 353-6000

450 Stanyan St
San Francisco, CA 94117
Phone (415) 668-1000

Interoperability endpoints

  • Direct secure messaging: chull457643@hisp.ehr.sutterhealth.org

Organizations & group practices 5

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.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1462147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563235200000",
    "number": "1972958627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 POWELL ST STE 400",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081826",
            "telephone_number": "510-350-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 LONE TREE WAY",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "94509",
            "telephone_number": "925-779-7200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3635 Vista Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631102539",
            "country_code": "US",
            "telephone_number": "512-348-1311",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3635 Vista Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631102539",
            "country_code": "US",
            "telephone_number": "512-348-1311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HULL",
        "first_name": "CHARLOTTE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-02",
        "last_updated": "2019-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "20A17162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Antioch, CA

Sources for this page

Verify at the official NPI Registry.