EAST BAY ENT FAC PLAS SG MD GRP INC (NPI# 1902099765) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902099765 |
| Entity Type | Organization |
| Organization Name | EAST BAY ENT FAC PLAS SG MD GRP INC |
| Practice Address |
5401 Norris Canyon Rd Suite 302 San Ramon CA 94583-5409 |
| Practice Telephone | 9252779000 |
| Mailing Telephone | 9252779000 |
| Enumeration Date | 2007-08-23 |
| Last Update Date | 2007-08-23 |
| Authorized Official Name | STEPHEN LARMORE (OWNER) |
| Authorized Official Telephone | 9252779000 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 302F00000X | Exclusive Provider Organization | C031854 | CA | Managed Care Organizations |
| Street Address |
5401 NORRIS CANYON RD SUITE 302 |
| City | SAN RAMON |
| State | CA |
| Zip Code | 94583-5409 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588668206 | Anthony Joseph Rega | Dentist | 5401 Norris Canyon Rd, Ste 210, San Ramon, CA 94583-5408 | 2005-06-09 |
| 1376875625 | Valley Digestive Care | Specialist | 5401 Norris Canyon Rd, Suite 208, San Ramon, CA 94583-5409 | 2010-02-10 |
| 1447581624 | M Michael Kazemi Md A Medical Corporation | Internal Medicine | 5401 Norris Canyon Rd, Suite 308, San Ramon, CA 94583-5409 | 2010-01-27 |
| 1225369507 | Diablo Valley Critical Care PC | Internal Medicine | 5401 Norris Canyon Rd, 308, San Ramon, CA 94583-5409 | 2010-01-26 |
| 1306174586 | Shelley S Krompier | Social Worker | 5401 Norris Canyon Rd, Suite 314, San Ramon, CA 94583-5409 | 2009-11-25 |
| 1235382334 | Anupama Ganga | Physical Medicine & Rehabilitation | 5401 Norris Canyon Rd, Suite 102, San Ramon, CA 94583-5409 | 2008-11-03 |
| 1629249065 | Sheryl Coloma Militar | Pediatrics | 5401 Norris Canyon Rd, Suite 304 - Tri Valley Pediatrics, San Ramon, CA 94583-5409 | 2008-03-13 |
| 1457550972 | Philip Yee, Md, Inc. | Internal Medicine | 5401 Norris Canyon Rd, Suite 208, San Ramon, CA 94583-5409 | 2007-07-14 |
| 1528261500 | Anitha Angan | Internal Medicine | 5401 Norris Canyon Rd, Ste 308, San Ramon, CA 94583-5408 | 2007-06-07 |
| 1619197225 | M. Michael Kazemi, M.d. | Internal Medicine | 5401 Norris Canyon Rd, #308, San Ramon, CA 94583-5409 | 2007-04-26 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295375475 | Angel Beatrice Mckneely | Behavior Technician | 3150 Crow Canyon Place, Suite 110, San Ramon, CA 94583 | 2020-01-15 |
| 1205302247 | Asma Parisa Rezaye | Behavior Technician | 4708 Norris Canyon Rd, Unit 201, San Ramon, CA 94583 | 2018-10-17 |
| 1679055461 | Mary Martineau | Speech-Language Pathologist | 210 Porter Dr Ste 120, San Ramon, CA 94583 | 2018-08-29 |
| 1336631332 | Alison Jean Barnes | Behavior Technician | Goals for Autism, 1 Crow Canyon Court, San Ramon, CA 94583 | 2018-06-05 |
| 1730671975 | Michael Federico | Pharmacist | 2735 Ascot Drive, San Ramon, CA 94583 | 2018-06-04 |
| 1508384843 | Donor Network West | Organ Procurement Organization | 12667 Alcosta Blvd., Suite 500, San Ramon, CA 94583 | 2017-09-07 |
| 1265950141 | Danielle Lustig Fitch | Marriage & Family Therapist | 3180 Crown Canyon Pl. Ste 140, San Ramon, CA 94583 | 2017-08-31 |
| 1386166205 | Park Place Ambulatory Surgery Center | Orthopaedic Surgery | 100 Park Place, Suite 100, San Ramon, CA 94583 | 2017-07-12 |
| 1952822991 | Virginia Rutledge Mosby | Marriage & Family Therapist | 3180 Crow Canyon Place #140, San Ramon, CA 94583 | 2017-06-29 |
| 1437684784 | Nakhla Dental Group | Dentist | Crow Canyon Dental, 2821 Crow Canyon Road #200, San Ramon, CA 94583 | 2017-04-25 |
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| Taxonomy Code | 302F00000X |
| Grouping | Managed Care Organizations |
| Classification | Exclusive Provider Organization |
| (1) An EPO is a form of PPO, in which patients must visit a caregiver that is specified on its panel of providers (is a participating provider). If a visit to an outside(not participating) provider is made the EPO offers very limited or no coverage for the medical service; (2) While similar to a PPO in that an EPO allows patients to go outside the network for care, if they do so in an EPO, they are required to pay the entire cost of care. An EPO differs from an HMO in that EPO physicians do not receive capitation but instead are reimbursed only for actual services provided; (3) An organization identical to a preferred provider organization except that persons enrolled in the plan are eligible to receive benefits only when they use the services of the contracting providers. No benefits are available when non-contracting providers are used, except in certain emergency situations. |
| Notes: Source: (1) Medical Interface: Managed Care A thru Z- Managed Care Terms published by Medicom International, Bronxville, New York Telephone (914) 337-5023, p. 15; (2) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 58; (3) Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
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|---|---|---|---|---|
| 1669021150 | Silky Touch LLC | Exclusive Provider Organization | 2551 San Ramon Valley Blvd Ste 107b, San Ramon, CA 94583-1661 | 2019-09-06 |
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| 1922586114 | Primary Care Associates of California of San Diego, Inc. | Exclusive Provider Organization | 10833 Valley View St Ste 570, Cypress, CA 90630-5061 | 2018-07-31 |
| 1962949057 | Sol Play Child Therapy Inc | Exclusive Provider Organization | 5811 Amaya Dr Ste 204, La Mesa, CA 91942-4156 | 2017-01-26 |
| 1841735511 | E.moawad Dental Corporation | Exclusive Provider Organization | 402 S Long Beach Blvd, Compton, CA 90221-3428 | 2017-01-04 |
| 1538512744 | Azila Katherine Sabile Ortiz | Exclusive Provider Organization | 15260 Amalia St, San Diego, CA 92129-1228 | 2016-07-22 |
| 1730534330 | Northern California Physicians Network Inc | Exclusive Provider Organization | 2331 Montpelier Dr, San Jose, CA 95116-1688 | 2016-05-02 |
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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.