BAY AREA SPORTS ORTHOPAEDICS, INC (NPI# 1598811796) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598811796 |
| Entity Type | Organization |
| Organization Name | BAY AREA SPORTS ORTHOPAEDICS, INC |
| Practice Address |
3300 Webster St Suite 907 Oakland CA 94609-3117 |
| Mailing Address |
1563 Solano Ave Suite 336 Berkeley CA 94707-2116 |
| Practice Telephone | 5108342276 |
| Practice Fax Number | 5108342202 |
| Mailing Telephone | 5108342276 |
| Mailing Fax Number | 5108342202 |
| Enumeration Date | 2007-01-28 |
| Last Update Date | 2014-08-05 |
| Authorized Official Name | DAVID S CHANG (PRESIDENT) |
| Authorized Official Telephone | 5108342276 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
A87115 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
3300 WEBSTER ST SUITE 907 |
| City | OAKLAND |
| State | CA |
| Zip Code | 94609-3117 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073517603 | James K. Mooney | Specialist | 3300 Webster St, Ste 710, Oakland, CA 94609-3117 | 2005-06-10 |
| 1174970461 | Malboubi Dental Corporation | Dentist | 3300 Webster St, Suite 905, Oakland, CA 94609-3117 | 2016-05-17 |
| 1245607456 | Hill Health Inc A Medical Corporation | Family Medicine | 3300 Webster St, Oakland, CA 94609-3117 | 2015-08-24 |
| 1669879714 | Catherine Logan Maier | Registered Nurse | 3300 Webster St, Suite 1200, Oakland, CA 94609-3117 | 2014-12-03 |
| 1124420658 | Brianna Nicole Cosentino | Physical Therapist | 3300 Webster St, 1201, Oakland, CA 94609-3117 | 2014-09-16 |
| 1477966919 | Jessica Tice | Physical Therapist | 3300 Webster St, 703, Oakland, CA 94609-3117 | 2014-06-03 |
| 1205174505 | Kelly Lee Wong | Internal Medicine | 3300 Webster St, 1000, Oakland, CA 94609-3117 | 2013-01-21 |
| 1770885741 | Rachel L Kay | Nurse Practitioner | 3300 Webster St, Suite 304, Oakland, CA 94609-3117 | 2010-11-24 |
| 1306146568 | Carolyn Jacobs Bernstein | Nurse Practitioner | 3300 Webster St, Oakland, CA 94609-3117 | 2010-10-21 |
| 1528378460 | John Alexander Gillean | Psychiatry & Neurology | 3300 Webster St, Suite 402, Oakland, CA 94609-3117 | 2010-10-13 |
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| 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 |
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| Taxonomy Code | 207XX0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Sports Medicine |
| An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457596629 | Scott M Taylor Md Professional Corporation | Orthopaedic Surgery | 400 29th St, Suite #400, Oakland, CA 94609-3522 | 2008-12-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790341618 | Casey S Revenko | Orthopaedic Surgery | 2999 Regent St Ste 225, Berkeley, CA 94705-2117 | 2019-05-15 |
| 1225504301 | Amgad Alfred | Orthopaedic Surgery | 18145 Us Highway 18 Ste D, Apple Valley, CA 92307-2210 | 2018-10-16 |
| 1386136430 | Valley River Orthopedics and Sports Medicine | Orthopaedic Surgery | Valley River Orthopedics & Sports Medicine Inc, 3329 G St Ste A, Merced, CA 95340 | 2018-06-05 |
| 1073026696 | Optimal Physician Surgical Group | Orthopaedic Surgery | 25067 Jim Bridger Rd, Hidden Hills, CA 91302-1128 | 2017-11-06 |
| 1336669456 | Beach Cities Orthopedics Surgery Center, LLC | Orthopaedic Surgery | 400 S Sepulveda Blvd Ste 110, Manhattan Beach, CA 90266-6814 | 2017-06-20 |
| 1750818860 | Health Link Medical Group Inc | Orthopaedic Surgery | 899 Northgate Dr Ste 400, San Rafael, CA 94903-3667 | 2017-05-19 |
| 1962861476 | Mehta Orthopedics | Orthopaedic Surgery | 32145 Alvarado Niles Rd Ste 209, Union City, CA 94587-2930 | 2016-02-12 |
| 1649646282 | Bay Area Surgical Specialists, Inc. A Medical Corporation | Orthopaedic Surgery | 5924 Stoneridge Dr Ste 202, Pleasanton, CA 94588-5400 | 2015-08-18 |
| 1114346111 | Sean Robinson | Orthopaedic Surgery | 7551 Timberlake Way Ste 200, Sacramento, CA 95823-5422 | 2014-04-08 |
| 1851717938 | William R Campbell Do Prof Corp | Orthopaedic Surgery | 1 Daniel Burnham Ct Ste 365c, San Francisco, CA 94109-5490 | 2014-03-12 |
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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.