ADDISON LEE MCMURTRY (MD) – Vascular Surgery Physician, NPI 1669550398

ADDISON LEE MCMURTRY (MD) is a healthcare provider. based in Oakland, California. specializing in VASCULAR SURGERY. They hold the professional credentials MD. They hold a License No. A60380 (CA). The NPI Number for ADDISON LEE MCMURTRY (MD) is 1669550398

Main info

Male
32 Years Of Experience
Accepts Medicare Assignment
Name
ADDISON LEE MCMURTRY (MD)
NPI
1669550398
Phone
(510) 625-6262
Address
1800 HARRISON ST FL 7
Enumeration Date
1 November 2006
Last Update Date
8 December 2021

Doctor Profile

Medical School Name
TULANE UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
9167844000
Graduation Year
1994 (32 years ago)
PAC ID
0547457459
Group Practice PAC ID
8921910225
Professional Enrollment ID
I20101203001092
Address ID
CA956613027RO1600XRDXX300

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness85
Years active:19State licenses:1Other namesUpdated within 12 months

675 VASCULAR SURGERY in CA

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Provider Addresses for ADDISON LEE MCMURTRY (MD)

  • Harrison Street, Chinatown, Oakland, Alameda County, California, 94607, United States

    OAKLAND, CA 946123466

    Phone: (510) 625-6262

    Type: Mailing

  • Kaiser Permanente Roseville Medical Center, 1600, Eureka Road, Roseville, Placer County, California, 95661, United States

    ROSEVILLE, CA 956613027

    Phone: (916) 784-4000

    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: 2010-12-03

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
I20101203001092IVascular SurgeryCATBD

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 94612)

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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: 8921910225View full group profile
NameSpecialtyState
Emergency MedicineDC
Colorectal Surgery (Proctology), General SurgeryLA
-CA
N E U R O S U R G E R YMA
Internal MedicineCA
Nurse PractitionerCA
Internal MedicineCA
Emergency MedicineCA
-MA
Emergency MedicineCA

Reviews

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Frequently asked questions

What is ADDISON LEE MCMURTRY (MD)'s NPI number?
ADDISON LEE MCMURTRY (MD)'s NPI is 1669550398 — the number used across U.S. healthcare to identify this provider.
Is ADDISON LEE MCMURTRY (MD) still an active registrant?
ADDISON LEE MCMURTRY (MD) carries an active NPI according to the public dataset.
What kind of doctor is ADDISON LEE MCMURTRY (MD)?
ADDISON LEE MCMURTRY (MD) is associated with Vascular Surgery Physician in the directory — Clinical services aligned with this taxonomy classification.
Is ADDISON LEE MCMURTRY (MD) associated with Oakland?
Public fields place ADDISON LEE MCMURTRY (MD) around Oakland, California. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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