DR. BEHRAM R SOONAWALA (M.D.) – Internal Medicine Physician, NPI 1104895085

DR. BEHRAM R SOONAWALA (M.D.) is a healthcare provider. based in Berkeley, California. specializing in Internal Medicine Physician. They hold the professional credentials M.D.. They hold a License No. A64516 (CA). The NPI Number for DR. BEHRAM R SOONAWALA (M.D.) is 1104895085

Main info

Male
35 Years Of Experience
Accepts Medicare Assignment
Name
DR. BEHRAM R SOONAWALA (M.D.)
NPI
1104895085
Phone
(510) 525-8980
Address
1510 4TH ST
Enumeration Date
14 March 2006
Last Update Date
9 July 2008

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7075463210
Graduation Year
1991 (35 years ago)
PAC ID
4789677873
Group Practice PAC ID
3274421532
Professional Enrollment ID
I20040405001636
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for DR. BEHRAM R SOONAWALA (M.D.)

  • 1510, Fourth Street, Ocean View, Berkeley, Alameda County, California, 94710, United States

    SUITE 1

    BERKELEY, CA 947101717

    Phone: (510) 525-8980

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-04-05

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040405001636IInternal MedicineCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 94710)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3274421532View full group profile

Reviews

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Frequently asked questions

Does DR. BEHRAM R SOONAWALA (M.D.) have a public NPI I can cite?
Public records show DR. BEHRAM R SOONAWALA (M.D.) under NPI 1104895085.
Is DR. BEHRAM R SOONAWALA (M.D.)'s NPI status active today?
Active status means DR. BEHRAM R SOONAWALA (M.D.)'s NPI record is not deactivated in the public file.
Which specialty label fits DR. BEHRAM R SOONAWALA (M.D.)?
NPPES ties DR. BEHRAM R SOONAWALA (M.D.) to Internal Medicine Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.
What city is tied to DR. BEHRAM R SOONAWALA (M.D.)?
The directory associates DR. BEHRAM R SOONAWALA (M.D.) with Berkeley, California. Check all listed addresses for suites or satellite offices.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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Unknown Individual

Internal Medicine Physician
1510, Fourth Street, Ocean View, Berkeley, Alameda County, California, 94710, United States
NPI: 1992773352