Oliver K Khakmahd (NPI# 1164529830, PAC ID# 6204843303) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NEPHROLOGY.
| Nation Provider ID (NPI) | 1164529830 |
| PAC ID by PECOS | 6204843303 |
| Professional Enrollment ID | I20080624000217 |
| Full Name | Oliver K Khakmahd |
| Organization Legal Name | EAST BAY NEPHROLOGY MEDICAL GROUP, INC. |
| Address |
3043 Summit St Oakland CA 94609-3408 |
| Phone Number | 5106258310 |
| Gender | M |
| Graduation Year | 1989 |
| Primary Specialty | NEPHROLOGY |
| Secondary Specialties | INTERNAL MEDICINE |
| Group Practice PAC ID | 1759377757 |
| Number of Group Practice Members | 25 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 050043 | ALTA BATES SUMMIT MEDICAL CENTER |
| 050305 | ALTA BATES SUMMIT MEDICAL CENTER - ALTA BATES CAMP |
| Address | Phone | Organization |
|---|---|---|
| 2905 Telegraph Ave, Berkeley, CA 94705-2017 | 5108410411 | EAST BAY NEPHROLOGY MEDICAL GROUP, INC. |
| 3012 Summit St, Oakland, CA 94609-3480 | 5102511002 | DIALYSIS ACCESS CENTER A MEDICAL CORPORATION |
| 3043 Summit St, Oakland, CA 94609-3408 | 5106258310 | EAST BAY NEPHROLOGY MEDICAL GROUP, INC. |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % | |
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % | |
| MIPS_EC_047_overall | Care Plan | 73% | |
| MIPS_EC_047_overall | Care Plan | 73% | |
| MIPS_EC_145_overall | Radiology: Exposure Dose or Time Reported for Procedures Using Fluoroscopy | 98% | |
| MIPS_EC_145_overall | Radiology: Exposure Dose or Time Reported for Procedures Using Fluoroscopy | 98% |
| Organization Legal Name | EAST BAY NEPHROLOGY MEDICAL GROUP, INC. |
| Physicians | 30 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ellen C Morrissey | Nephrology | East Bay Nephrology Medical Group, Inc. | 2905 Telegraph Ave, Berkeley, CA 94705-2017 |
| Robert B Doud | Nephrology | East Bay Nephrology Medical Group, Inc. | 125 Hospital Dr, Vallejo, CA 94589-2562 |
| Donald A Block | Nephrology | East Bay Nephrology Medical Group, Inc. | 2905 Telegraph Ave, Berkeley, CA 94705-2017 |
| Samuel J Wong | Nephrology | East Bay Nephrology Medical Group, Inc. | 125 Hospital Dr, Vallejo, CA 94589-2562 |
| Katherine Rausa | Nephrology | East Bay Nephrology Medical Group, Inc. | 125 Hospital Dr, Vallejo, CA 94589-2562 |
| Veena Manjunath | Nephrology | East Bay Nephrology Medical Group, Inc. | 125 Hospital Dr, Vallejo, CA 94589-2562 |
| Golaun Odabaei | Nephrology | East Bay Nephrology Medical Group, Inc. | 2905 Telegraph Ave, Berkeley, CA 94705-2017 |
| Suzanne D Lee | Registered Dietitian Or Nutrition Professional | East Bay Nephrology Medical Group, Inc. | 2905 Telegraph Ave, Berkeley, CA 94705-2017 |
| Bryan M Wong | Nephrology | East Bay Nephrology Medical Group, Inc. | 3043 Summit St, Oakland, CA 94609-3408 |
| Denise M Ricker | Nephrology | East Bay Nephrology Medical Group, Inc. | 125 Hospital Dr, Vallejo, CA 94589-2562 |
| Street Address |
3043 SUMMIT ST |
| City | OAKLAND |
| State | CA |
| Zip | 94609-3408 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Bryan M Wong | Nephrology | East Bay Nephrology Medical Group, Inc. | 3043 Summit St, Oakland, CA 94609-3408 |
| Terina M Miller | Nephrology | East Bay Nephrology Medical Group, Inc. | 3043 Summit St, Oakland, CA 94609-3408 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Virginia A Frederick | Chiropractic | 6434 Telegraph Ave, Oakland, CA 94609-1112 | |
| Douglas B Ross | Chiropractic | 6434 Telegraph Ave, Oakland, CA 94609-1112 | |
| Andrea L Long | Physical Therapy | Sports and Orthopedic Specialists | 6300 Telegraph Ave, Oakland, CA 94609-1329 |
| Richard W Burg | Chiropractic | 6330 Telegraph Ave, Oakland, CA 94609-1329 | |
| Lisa Gibson | Physical Therapy | Sports and Orthopedic Specialists | 6300 Telegraph Ave, Oakland, CA 94609-1329 |
| Dawn J Loretz | Physical Therapy | Sports and Orthopedic Specialists | 6300 Telegraph Ave, Oakland, CA 94609-1329 |
| Kathryn Rittenberg | Physical Therapy | Sports and Orthopedic Specialists | 6300 Telegraph Ave, Oakland, CA 94609-1329 |
| Nancy Kathleen Bryan | Physical Therapy | Sports and Orthopedic Specialists | 6300 Telegraph Ave, Oakland, CA 94609-1329 |
| Chelsea S Landolin | Nurse Practitioner | Bonita House, Inc. | 6333 Telegraph Ave, Suite 102, Oakland, CA 94609-1359 |
| Manton S Hurd | Nurse Practitioner | Bonita House, Inc. | 6333 Telegraph Ave, Suite 102, Oakland, CA 94609-1359 |
| Find all physicians in zip 94609 | |||
| City | OAKLAND |
| Zip Code | 94609 |
| Specialty | NEPHROLOGY |
| City + Specialty | OAKLAND + NEPHROLOGY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.