AVIS ETTA LOGAN (MD) – Family Medicine Physician, NPI 1235102252
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
13,190 FAMILY PRACTICE in CA
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Provider Addresses for AVIS ETTA LOGAN (MD)
Treat Boulevard, Walnut Creek, Contra Costa County, California, 94519, United States
WALNUT CREEK, CA 945972168
Phone: (925) 952-2888
Type: Mailing
San Pablo Avenue, San Pablo Park, Berkeley, Alameda County, California, 94608, United States
BERKELEY, CA 94702
Phone: (510) 985-5020
Type: Location
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: 2008-07-14
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20080714000209 | I | Family Practice | CA | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 271 | 167 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 181 | 132 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 165 | 165 | $0 |
| 90694 | Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage | 48 | 48 | $0 |
| G0008 | Administration of influenza virus vaccine | 47 | 47 | $0 |
Insurance plans in this area (ZIP 94597)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| FAMILY MEDICINE | CA | 90670 | Pneumococcal vaccine for injection into muscle | 40 | 40 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine, Pediatric Medicine | CA | |
| Family Practice | CA | |
| - | CA | |
| - | CA | |
| U R O L O G Y | CA | |
| Internal Medicine, Hospitalist | CA | |
| - | CA | |
| Internal Medicine | CA | |
| Hospice/Palliative Care, Internal Medicine | CA | |
| Physician Assistant | CA |
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