Individual provider Active NPI

Andrea Zatlin Stark, M.D.

  • Anesthesiology Physician
  • Danville, CA
National Provider Identifier
1992778757
Registry record updated Feb 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A120203 Issued in CA
Practice address
1182 River Rock LN
Danville, CA 94526-4004
Phone
(480) 272-1060
NPI assigned
Feb 10, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 34951 AZ
Anesthesiology Physician 207L00000X A120203 CA Primary

Addresses

Primary practice location

1182 River Rock LN
Danville, CA 94526-4004

Mailing address

1182 River Rock LN
Danville, CA 94526-4004
Phone (480) 272-1060

Other names 1

  • Dr. Andrea Zatlin Former name

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
I20121203000485 CA Practitioner - Anesthesiology 5294987996 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of California, San Francisco School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alameda Anesthesia Associates Medical Group IncGroup PAC ID 4688642028, 20 clinicians

Practice addresses (Care Compare)

20103 Lake Chabot Rd
Castro Valley, CA 94546-5305
Phone (510) 537-1234

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34951AZMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alameda Anesthesia Associates Medical Group, Inc Anesthesiology CurrentSince Jan 4, 2014 Accepting new patients

Locations

20103 Lake Chabot Rd
Hayward, CA 94546
Phone (510) 537-1234

Interoperability endpoints

  • Direct secure messaging: astark195090@hisp.ehr.sutterhealth.org

Organizations & group practices 1

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 1

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": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330128000000",
    "number": "1992778757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1182 RIVER ROCK LN",
            "city": "DANVILLE",
            "state": "CA",
            "postal_code": "945264004",
            "telephone_number": "480-272-1060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1182 RIVER ROCK LN",
            "city": "DANVILLE",
            "state": "CA",
            "postal_code": "945264004",
            "telephone_number": "480-272-1060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "ANDREA",
        "middle_name": "ZATLIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-10",
        "last_updated": "2012-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "34951",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A120203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "ZATLIN",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Danville, CA

Sources for this page

Verify at the official NPI Registry.