SUMMIT ENT MEDICAL ASSOCIATES (NPI# 1528020609) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528020609 |
| Entity Type | Organization |
| Organization Name | SUMMIT ENT MEDICAL ASSOCIATES |
| Practice Address |
2961 Summit St Suite 1 Oakland CA 94609-3482 |
| Practice Telephone | 5104650941 |
| Practice Fax Number | 5104650941 |
| Mailing Telephone | 5104650941 |
| Mailing Fax Number | 5104650941 |
| Enumeration Date | 2006-04-04 |
| Last Update Date | 2010-08-23 |
| Authorized Official Name | DR. ANDREW W. MOYCE (PRESIDENT) |
| Authorized Official Telephone | 5104650941 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | BLUE SHIELD | ZZZ49994Z | 01 |
| CA | GR0067410 | 05 |
| Street Address |
2961 SUMMIT ST SUITE 1 |
| City | OAKLAND |
| State | CA |
| Zip Code | 94609-3482 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033512348 | Dereck Hr Byrd | Counselor | 2961 Summit St, Oakland, CA 94609-3482 | 2014-09-30 |
| 1497050249 | Summit Hearing Assist, LLC | Audiologist | 2961 Summit St, Suite 2, Oakland, CA 94609-3482 | 2011-01-25 |
| 1437465028 | Kelly Tremmel-howell | Audiologist | 2961 Summit St, Suite 2, Oakland, CA 94609-3482 | 2010-08-20 |
| 1194058925 | Gregory Lh Gayle | Psychologist | 2961 Summit St, Oakland, CA 94609-3482 | 2009-09-11 |
| 1801053350 | David Shelby Hicks | Audiologist | 2961 Summit St, Suite #2, Oakland, CA 94609-3482 | 2008-05-21 |
| 1952568404 | Jessa Nicole Muscio Traylor | Audiologist | 2961 Summit St, Suite #2, Oakland, CA 94609-3482 | 2008-05-21 |
| 1124081112 | William B. Lewis | Otolaryngology | 2961 Summit St, Suite 1, Oakland, CA 94609-3482 | 2006-04-10 |
| 1194788778 | Bernard J. Drury | Otolaryngology | 2961 Summit St, Suite 1, Oakland, CA 94609-3482 | 2006-04-06 |
| 1710949896 | Andrew Moyce | Otolaryngology | 2961 Summit St, Suite 1, Oakland, CA 94609-3482 | 2006-04-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104457159 | Gerard John-charles Coughlin | Student in an Organized Health Care Education/Training Program | Samuel Merritt University, 3100 Telegraph Avenue, Oakland, CA 94609 | 2020-01-29 |
| 1417502022 | Michael Knittel | Registered Nurse | 370 Hawthorne Ave, Oakland, CA 94609 | 2019-08-09 |
| 1962057562 | Nicole Kjolby | Registered Nurse | Samuel Merritt College, 370 Hawthorne Ave, Oakland, CA 94609 | 2019-08-09 |
| 1396208286 | Graham Vallis | Student in an Organized Health Care Education/Training Program | Ucsf Benioff Children's Hospital Oakland, 747 52nd Street, Oakland, CA 94609 | 2019-04-09 |
| 1386129526 | Gary Mitchell Snider | Counselor | 390 40th Street, Oakland, CA 94609 | 2018-10-02 |
| 1720568389 | Lice Control Inc. | Technician | 6557 Shattuck Ave, Oakland, CA 94609 | 2018-08-14 |
| 1528559150 | Jenna Marie Kincaid | Behavior Technician | 400 29th St., 204, Oakland, CA 94609 | 2018-05-18 |
| 1336656669 | Nicholas Dicarlo | Social Worker | 465 34th St Ste 6, Oakland, CA 94609 | 2018-01-09 |
| 1174045744 | Theodora J Marzouk | Home Health Aide | 3317 Elm Street, Suite 202, Oakland, CA 94609 | 2017-07-14 |
| 1740728922 | Elena Gardella | Marriage & Family Therapist | 411 30th Street, Suite 412, Oakland, CA 94609 | 2017-02-07 |
| Find all providers in zip 94609 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962918078 | Ira Sanders | Otolaryngology | 5 Rye Cliff Rd, Oakland, NJ 07436-1423 | 2017-12-27 |
| 1356868954 | University Healthcare Alliance | Otolaryngology | 350 30th St Ste 311, Oakland, CA 94609-3425 | 2017-08-24 |
| 1124480736 | Christopher Xiao | Otolaryngology | 275 W Macarthur Blvd, Oakland, CA 94611-5641 | 2016-03-23 |
| 1457745747 | Barcleigh Paige Landau | Otolaryngology | 3600 Broadway, 4th Floor, Head and Neck Surgery, Oakland, CA 94611-5730 | 2015-03-24 |
| 1508124132 | Jason Gilde | Otolaryngology | 280 W Macarthur Blvd, Oakland, CA 94611-5642 | 2012-05-02 |
| 1871889709 | Tristan Klosterman | Otolaryngology | 1411 E 31st St, Oakland, CA 94602-1018 | 2011-06-20 |
| 1174842835 | Wade R. Cartwright M.d. A Professional Corporation | Otolaryngology | 411 30th St, Suite 401, Oakland, CA 94609-3310 | 2010-05-20 |
| 1528382801 | Stephen V. Tornabene | Otolaryngology | 280 W Macarthur Blvd, Gme Office, Room 1118, Oakland, CA 94611-5642 | 2010-03-16 |
| 1790012839 | Megan Leigh Durr | Otolaryngology | 275 W Macarthur, Oakland, CA 94611-5641 | 2009-11-10 |
| 1083866602 | Luke J. Schloegel | Otolaryngology | 275 W Macarthur, Oakland, CA 94611-5641 | 2008-10-14 |
| Find all providers in OAKLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.