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PINE PARK HEALTH, INC
NPI 1346879848
Internal Medicine in Berkeley, CA

Active since April 06, 2020CLIA 03D2269060 · Waiver
1901 4TH ST STE 201, BERKELEY, CA 94710(510) 929-1400(510) 929-1414 Get Directions Write a Review

NPPES record last updated: September 2, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Sep 2, 2026, Feb 4, 2025, Sep 7, 2023 and 5 more (8 updates tracked since 2020).

About Pine Park Health, Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PINE PARK HEALTH, INC (NPI 1346879848) is a healthcare organization registered as an internal medicine in Berkeley, California and active in the NPI registry since April 2020. The organization holds a CLIA Waiver certificate valid through September 19, 2028, maintains 6 additional practice locations, and lists Ariel Cable, Credentialing Manager, as its authorized official.

NPPES Registry Identity

NPI1346879848
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NamePINE PARK HEALTH, INC
Location Address1901 4TH ST STE 201Berkeley, CA 94710-1986
Mailing AddressPo Box 511250Los Angeles, CA 90051-7805 · (510) 929-1400 · Fax (510) 929-1414
Phone(510) 929-1400
Fax(510) 929-1414
Organization SubpartNo
Authorized OfficialAriel CableCredentialing Manager · (480) 475-6531
Enumeration DateApril 6, 2020
Last NPPES UpdateSeptember 2, 20268 updates tracked since enumeration
NPPES CertifiedSeptember 2, 2026
✔ NPI 1346879848 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 11

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedFamily Medicine · Adult MedicineTaxonomy 207QA0505X
Also ListedFamily Medicine · Geriatric MedicineTaxonomy 207QG0300X
Also ListedPhysician AssistantTaxonomy 363A00000X
Also ListedNurse PractitionerTaxonomy 363L00000X
Also ListedNurse Practitioner · Acute CareTaxonomy 363LA2100X
Also ListedNurse Practitioner · Adult HealthTaxonomy 363LA2200X
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X
Also ListedNurse Practitioner · GerontologyTaxonomy 363LG0600X
Also ListedNurse Practitioner · Primary CareTaxonomy 363LP2300X
1901 4TH ST STE 201, Berkeley, CA 94710
Open in Google Maps ↗

Secondary Practice Locations 6

Location 19800 Glen Center DrSan Diego, CA 92131-1686 · Phone (858) 832-2500 · Fax (858) 400-3023
Location 2501 Via CasitasGreenbrae, CA 94904-1901 · Phone (510) 929-1400 · Fax (510) 929-1414
Location 32645 E Southern AveTempe, AZ 85282-7649 · Phone (623) 624-8280 · Fax (602) 835-0192
Location 419303 N New Tradition RdSun City West, AZ 85375-3806 · Phone (623) 624-8280 · Fax (602) 835-0192
Location 54500 Gilbert StOakland, CA 94611-4657 · Phone (510) 929-1400 · Fax (510) 929-1414
Location 616977 Healdsburg AveHealdsburg, CA 95448-3261 · Phone (510) 929-1400 · Fax (510) 929-1414

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Pine Park Health, Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

24

Medicare enrollment records show 24 clinicians reassign Medicare billing to Pine Park Health, Inc, which bills Medicare for the services they deliver. Of these, 11 practice at this address and 12 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 5

Nurse Practitioner19
Internal Medicine2
Family Practice1
General Practice1
Geriatric Medicine1

Nearest to this location (20)

See all 24
Mallory Dawson
Nurse Practitioner
NPI 1770444309
1901 4TH ST STE 201
Berkeley, CA 94710
(510) 929-1400
✔ PECOS✔ Accepts MedicareSame address
Brittany Demont, NP
Nurse Practitioner
NPI 1316692841
1901 4TH ST STE 201
Berkeley, CA 94710
(510) 929-1400
✔ PECOS✔ Accepts MedicareSame address
Ann Ebiner, FNP
Nurse Practitioner
NPI 1316264112
1901 4TH ST STE 201
Berkeley, CA 94710
(510) 929-1400
✔ PECOS✔ Accepts MedicareSame address
Laura Eichinger, FNP-C
Nurse Practitioner
NPI 1801662168
1901 4TH ST
Berkeley, CA 94710
(858) 832-2500
✔ PECOS✔ Accepts MedicareSame address
Amanda Ilag, AGNP
Nurse Practitioner
NPI 1114745783
1901 4TH ST STE 201
Berkeley, CA 94710
(510) 929-1400
✔ PECOS✔ Accepts MedicareSame address
Jessica Ndiritu, FNP
Nurse Practitioner
NPI 1205507142
1901 4TH ST
Berkeley, CA 94710
(510) 929-1400
✔ PECOS✔ Accepts MedicareSame address
Erin O'hair, NP
Nurse Practitioner
NPI 1710259361
1901 4TH ST
Berkeley, CA 94710
(510) 929-1400
✔ PECOS✔ Accepts MedicareSame address
Payam Parvinchiha, M.D.
Internal Medicine
NPI 1851690622
1901 4TH ST STE 201
Berkeley, CA 94710
(510) 929-1400
✔ PECOS✔ Accepts MedicareSame address
Margot Schmidt, DNP
Nurse Practitioner
NPI 1154130946
1901 4TH ST STE 201
Berkeley, CA 94710
(510) 929-1400
✔ PECOS✔ Accepts MedicareSame address
Anita Shah, N.P.
Nurse Practitioner
NPI 1932488467
1901 4TH ST STE 201
Berkeley, CA 94710
(510) 929-1400
✔ PECOS✔ Accepts MedicareSame address
Melissa Vourlitis, D.O.
Family Practice
NPI 1235236977
1901 4TH ST
Berkeley, CA 94710
(510) 929-1400
✔ PECOS✔ Accepts MedicareSame address
Edward Teare, APRN-BC
Nurse Practitioner
NPI 1871832287
1144 65TH ST STE F
Oakland, CA 94608
(510) 929-1400
✔ PECOS✔ Accepts Medicare1.6 mi
April Koehler, NP
Nurse Practitioner
NPI 1356157200
2 KORET WAY
San Francisco, CA 94143
(415) 476-1435
✔ PECOS✔ Accepts Medicare11 mi
Jeenaben Patel
Nurse Practitioner
NPI 1215329172
2410 MERCED ST
San Leandro, CA 94577
(510) 278-2700
✔ PECOS✔ Accepts Medicare13 mi
Lisa Rosenberg, MD
Geriatric Medicine
NPI 1326013764
6880 S MCCARRAN BLVD STE 5
Reno, NV 89509
(775) 398-1981
✔ PECOS✔ Accepts Medicare175 mi
Michael Feinberg, M.D.
General Practice
NPI 1841682036
1350 ARROYICO LN
Santa Barbara, CA 93108
(805) 969-4117
✔ PECOS✔ Accepts Medicare280 mi
Lauren Dewalt, AGNP
Nurse Practitioner
NPI 1346603248
3800 KILROY AIRPORT WAY STE 100
Long Beach, CA 90806
(562) 527-7600
✔ PECOS✔ Accepts Medicare364 mi
Melissa Mcdonald, FNP-C
Nurse Practitioner
NPI 1508698929
5 HUTTON CENTRE DR STE 950
Santa Ana, CA 92707
(855) 434-7763
✔ PECOS✔ Accepts Medicare380 mi
Carole Reilly
Nurse Practitioner
NPI 1730910167
5 HUTTON CENTRE DR STE 950
Santa Ana, CA 92707
(855) 434-7763
✔ PECOS✔ Accepts Medicare380 mi
Randolph Clark, M.D.
Internal Medicine
NPI 1568456036
2510 W DUNLAP AVE STE 290
Phoenix, AZ 85021
(602) 789-0344
✔ PECOS✔ Accepts Medicare644 mi
See all 24 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 03D2269060

Pine Park Health · Sun City West, AZ
Active · expires Sep 19, 2028
CLIA Number03D2269060
Laboratory TypeTesting In Alf
Certificate Effective DateSeptember 20, 2026
Certificate Expiration DateSeptember 19, 2028
Laboratory DirectorCannon M. Kendall
Laboratory Phone(510) 929-1400
Laboratory LocationPine Park Health19303 N New Tradition Rd, Sun City West, AZ 85375
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pine Park Health, Inc's NPI number?

The NPI number for Pine Park Health, Inc is 1346879848. It was assigned to this organization in the NPPES registry on April 6, 2020.

Where is Pine Park Health, Inc located?

Pine Park Health, Inc is located at 1901 4th St Ste 201, Berkeley, CA 94710. The listed phone number is (510) 929-1400.

What is Pine Park Health, Inc's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Pine Park Health, Inc enrolled in Medicare?

Yes. Pine Park Health, Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Pine Park Health, Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 24 clinicians in 5 Medicare specialties reassign their Medicare billing to Pine Park Health, Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (19), Internal Medicine (2) and Family Practice (1). Of these, 11 practice at this address and 12 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Pine Park Health, Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 03D2269060) is associated with this NPI, valid through September 19, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Pine Park Health, Inc was last updated on September 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.