{"schema":"gale.providerFacts/1","npi":"1427154103","url":"https://www.gale.care/providers/ca/oakland/michael-usem-md-1427154103","factsUrl":"https://www.gale.care/npi/1427154103.json","markdownUrl":"https://www.gale.care/npi/1427154103.md","generatedAt":"2026-11-03T00:57:06.146Z","exportId":"elig-ca-20261023T221350Z","factsHash":"6a22ebf92ef2d218","factsChangedAt":"2026-10-23T00:00:00.000Z","index":{"robots":"index","basis":"index-all"},"summary":"Michael Usem, MD (NPI 1427154103) is listed in the NPPES registry with the specialty Pediatrics Physician in Oakland, CA, phone (510) 433-1040, as of the registry file of Jun 8, 2026.","identity":{"name":{"id":"name","value":"Michael Usem","status":"self-reported","source":"nppes-registry","asOf":"2026-06-08","checkedAt":null,"staleAfter":null,"confidence":"high","gate":"G0","sentence":"The NPPES registry lists Michael Usem under NPI 1427154103, as of the registry file of Jun 8, 2026."},"credential":{"id":"credential","value":"MD","status":"self-reported","source":"nppes-registry","asOf":"2026-06-08","checkedAt":null,"staleAfter":null,"confidence":"high","gate":"G0","sentence":"The NPPES registry lists the credential MD for Michael Usem, MD (NPI 1427154103), as of the registry file of Jun 8, 2026."},"specialty":{"id":"specialty","value":"Pediatrics Physician","status":"self-reported","source":"nppes-registry","asOf":"2026-06-08","checkedAt":null,"staleAfter":null,"confidence":"high","gate":"G0","sentence":"The NPPES registry lists Michael Usem, MD (NPI 1427154103) under the specialty Pediatrics Physician, as of the registry file of Jun 8, 2026."},"registryStage":{"id":"registry-stage","value":"as-listed","status":"self-reported","source":"nppes-registry","asOf":"2026-06-08","checkedAt":null,"staleAfter":null,"confidence":"high","gate":"G0","sentence":"The NPPES registry does not list Michael Usem, MD (NPI 1427154103) under a training program, as of the registry file of Jun 8, 2026."},"npiIssued":{"id":"npi-issued","value":2006,"status":"confirmed","source":"nppes-registry","asOf":"2026-06-08","checkedAt":null,"staleAfter":null,"confidence":"high","gate":"G0","sentence":"The NPPES registry shows NPI 1427154103 (Michael Usem, MD) issued in 2006, as of the registry file of Jun 8, 2026."},"practiceType":{"id":"practice-type","value":"not-sole-proprietor","status":"self-reported","source":"nppes-registry","asOf":"2026-06-08","checkedAt":null,"staleAfter":null,"confidence":"high","gate":"G0","sentence":"The NPPES registry lists Michael Usem, MD (NPI 1427154103) as not a sole proprietor, as of the registry file of Jun 8, 2026."}},"location":{"city":{"id":"city","value":"Oakland","status":"self-reported","source":"nppes-registry","asOf":"2026-06-08","checkedAt":null,"staleAfter":null,"confidence":"high","gate":"G0","sentence":"The NPPES registry lists a practice location in Oakland for Michael Usem, MD (NPI 1427154103), as of the registry file of Jun 8, 2026."},"state":{"id":"state","value":"CA","status":"self-reported","source":"nppes-registry","asOf":"2026-06-08","checkedAt":null,"staleAfter":null,"confidence":"high","gate":"G0","sentence":"The NPPES registry lists a practice location in CA for Michael Usem, MD (NPI 1427154103), as of the registry file of Jun 8, 2026."}},"contact":{"phone":{"id":"phone","value":"(510) 433-1040","status":"self-reported","source":"nppes-registry","asOf":"2026-06-08","checkedAt":null,"staleAfter":null,"confidence":"high","gate":"G0","sentence":"The NPPES registry lists (510) 433-1040 as the practice phone for Michael Usem, MD (NPI 1427154103), as of the registry file of Jun 8, 2026."}},"care":{"newPatients":{"id":"new-patients","value":true,"status":"confirmed","source":"cigna-fhir-directory","asOf":"2026-09-20","checkedAt":"2026-10-22T21:36:04Z","staleAfter":"2026-12-19","confidence":"high","gate":"G4","sentence":"Cigna's directory listed Michael Usem, MD (NPI 1427154103) as taking new patients on Sep 20, 2026."},"video":{"id":"video","value":"both","status":"confirmed","source":"dhcs-mcp-274-listing","asOf":"2026-04-21","checkedAt":"2026-10-22T14:42:02Z","staleAfter":"2026-08-19","confidence":"medium","gate":"G5","sentence":"DHCS Medi-Cal plan network listing listed Michael Usem, MD (NPI 1427154103) for video and in-person visits on Apr 21, 2026. The state file is old; Gale found no newer one.","cautions":["stale"],"staleNote":"The state file is old; Gale found no newer one."}},"insurance":{"rows":[{"id":"ins-alameda-medi-cal","value":{"payer":"alameda","payerLabel":"Alameda Alliance for Health","line":"medi-cal","products":["CFMG"],"accepts":true,"setting":"both"},"status":"confirmed","source":"dhcs-mcp-274-listing","asOf":"2026-04-21","checkedAt":"2026-10-22T14:42:02Z","staleAfter":"2026-08-19","confidence":"medium","gate":"G3","sentence":"Listed: DHCS Medi-Cal plan network listing listed Michael Usem, MD (NPI 1427154103) for Alameda Alliance for Health Medi-Cal plans on Apr 21, 2026. The state file is old; Gale found no newer one.","cautions":["stale"],"staleNote":"The state file is old; Gale found no newer one."},{"id":"ins-bsc-commercial","value":{"payer":"bsc","payerLabel":"Blue Shield of California","line":"commercial","products":["ACCESS+ HMO","ACO HMO","CALPERS ACCESS +","CALPERS EPO","CCPOA HMO","MCSIG PPO","PPO DMHC NETWORK","PPO DOI BLUE SHIELD LIFE NETWORK"],"accepts":true,"setting":"office"},"status":"confirmed","source":"bsc-fhir-directory","asOf":"2026-10-22","checkedAt":"2026-10-22T16:50:39Z","staleAfter":"2027-04-20","confidence":"medium","gate":"G3","sentence":"Listed: Blue Shield of California's directory listed Michael Usem, MD (NPI 1427154103) for Blue Shield of California commercial plans on Oct 22, 2026. Gale checked 60 listings in this directory by hand on Oct 22, 2026; 23 were wrong, so confirm with the office.","cautions":["hand-check"]},{"id":"ins-bsc-marketplace","value":{"payer":"bsc","payerLabel":"Blue Shield of California","line":"marketplace","products":["IFP TRIO"],"accepts":true,"setting":"office"},"status":"confirmed","source":"bsc-fhir-directory","asOf":"2026-10-22","checkedAt":"2026-10-22T16:50:39Z","staleAfter":"2027-04-20","confidence":"medium","gate":"G3","sentence":"Listed: Blue Shield of California's directory listed Michael Usem, MD (NPI 1427154103) for Blue Shield of California individual and family plans on Oct 22, 2026. Gale checked 60 listings in this directory by hand on Oct 22, 2026; 23 were wrong, so confirm with the office.","cautions":["hand-check"]},{"id":"ins-cigna-commercial","value":{"payer":"cigna","payerLabel":"Cigna / Evernorth","line":"commercial","products":["PATHWELL CIGNA OA FLEX"],"accepts":true,"setting":"office"},"status":"confirmed","source":"cigna-fhir-directory","asOf":"2026-09-20","checkedAt":"2026-10-22T21:36:04Z","staleAfter":"2027-03-19","confidence":"high","gate":"G3","sentence":"Listed: Cigna's directory listed Michael Usem, MD (NPI 1427154103) for Cigna / Evernorth commercial plans on Sep 20, 2026. Gale checked 51 listings in this directory by hand on Oct 22, 2026; 3 were wrong, so confirm with the office.","cautions":["hand-check"]},{"id":"ins-healthnet-commercial","value":{"payer":"healthnet","payerLabel":"Health Net","line":"commercial","products":["CA Blue and Gold HMO","CA Large Group HMO","CA Medicare COB HMO","CA Medicare COB Point of Service","CA PPO Large and Small","CA Select I Point of Service","CA Smartcare Large Group","CA WholeCare Small Group HMO"],"accepts":true,"setting":null},"status":"confirmed","source":"healthnet-fhir-directory","asOf":"2026-10-19","checkedAt":"2026-10-22T21:25:40Z","staleAfter":"2027-04-17","confidence":"medium","gate":"G3","sentence":"Listed: Health Net's directory listed Michael Usem, MD (NPI 1427154103) for Health Net commercial plans on Oct 19, 2026. Gale checked 12 listings in this directory by hand on Oct 22, 2026; 6 were wrong, so confirm with the office.","cautions":["hand-check"]},{"id":"ins-medi-cal-ffs-medi-cal","value":{"payer":"medi-cal-ffs","payerLabel":"Medi-Cal fee-for-service","line":"medi-cal","products":["Medi-Cal FFS"],"accepts":true,"setting":null},"status":"confirmed","source":"dhcs-ffs-enrolled-2026-10-19","asOf":"2026-10-19","checkedAt":"2026-10-22T14:41:40Z","staleAfter":"2027-02-16","confidence":"high","gate":"G3","sentence":"Listed: DHCS Medi-Cal fee-for-service enrolment file listed Michael Usem, MD (NPI 1427154103) for Medi-Cal fee-for-service on Oct 19, 2026."},{"id":"ins-uhc-commercial","value":{"payer":"uhc","payerLabel":"UnitedHealthcare","line":"commercial","products":["CalPERS SignatureValue Alliance","SignatureValue Advantage HMO","SignatureValue Alliance","SignatureValue HMO","SignatureValue Harmony HMO"],"accepts":true,"setting":"office"},"status":"confirmed","source":"uhc-fhir-directory","asOf":"2026-10-23","checkedAt":"2026-10-23T17:42:33Z","staleAfter":"2027-04-21","confidence":"medium","gate":"G3","sentence":"Listed: UnitedHealthcare's directory listed Michael Usem, MD (NPI 1427154103) for UnitedHealthcare commercial plans on Oct 23, 2026. Gale checked 12 listings in this directory by hand on Oct 22, 2026; 6 were wrong, so confirm with the office.","cautions":["hand-check"]},{"id":"ins-uhc-medicare-advantage","value":{"payer":"uhc","payerLabel":"UnitedHealthcare","line":"medicare-advantage","products":["UnitedHealthcare Group Medicare Advantage (PPO)"],"accepts":true,"setting":"office"},"status":"confirmed","source":"uhc-fhir-directory","asOf":"2026-10-23","checkedAt":"2026-10-23T17:42:33Z","staleAfter":"2027-04-21","confidence":"medium","gate":"G3","sentence":"Listed: UnitedHealthcare's directory listed Michael Usem, MD (NPI 1427154103) for UnitedHealthcare Medicare Advantage plans on Oct 23, 2026. Gale checked 12 listings in this directory by hand on Oct 22, 2026; 6 were wrong, so confirm with the office.","cautions":["hand-check"]},{"id":"ins-aetna-commercial","value":{"payer":"aetna","payerLabel":"Aetna","line":"commercial","products":["Aetna Open Access Health Network Only","HMO","Open Access Aetna Health Network Only","Open Access Aetna Health Network Option","QPOS"],"accepts":null,"setting":null},"status":"inferred","source":"aetna-tic-2026-10","asOf":"2026-10-05","checkedAt":"2026-10-22T17:01:05Z","staleAfter":"2027-04-03","confidence":"low","gate":"G3i","sentence":"Likely: Aetna's price file suggests Aetna pays Michael Usem, MD (NPI 1427154103) for commercial plans (file of Oct 5, 2026). That is a lead, not a directory listing."},{"id":"ins-anthem-commercial","value":{"payer":"anthem","payerLabel":"Anthem Blue Cross","line":"commercial","products":["CA DIGNITY HEALTH ECHW","CA EPO BLUE CONNECTION","CA EPO HIGH PERFORMANCE","CA EPO HIGH PERFORMANCE FALL-THRU MIX F","CA EPO USC TIER 1","CA HMO ADVANTAGE","CA HMO ADVANTAGE PLUS CC55","CA HMO ADVANTAGE TIER 1"],"accepts":null,"setting":null},"status":"inferred","source":"anthem-tic-2026-10","asOf":"2026-10-01","checkedAt":"2026-10-22T17:01:10Z","staleAfter":"2027-03-30","confidence":"low","gate":"G3i","sentence":"Likely: Anthem Blue Cross's price file suggests Anthem Blue Cross pays Michael Usem, MD (NPI 1427154103) for commercial plans (file of Oct 1, 2026). That is a lead, not a directory listing."},{"id":"ins-anthem-marketplace","value":{"payer":"anthem","payerLabel":"Anthem Blue Cross","line":"marketplace","products":["CA EPO Pathway","CA HMO Pathway"],"accepts":null,"setting":null},"status":"inferred","source":"anthem-tic-2026-10","asOf":"2026-10-01","checkedAt":"2026-10-22T17:01:10Z","staleAfter":"2027-03-30","confidence":"low","gate":"G3i","sentence":"Likely: Anthem Blue Cross's price file suggests Anthem Blue Cross pays Michael Usem, MD (NPI 1427154103) for individual and family plans (file of Oct 1, 2026). That is a lead, not a directory listing."},{"id":"ins-anthem-workers-comp","value":{"payer":"anthem","payerLabel":"Anthem Blue Cross","line":"workers-comp","products":["CA WORKERS COMP PERCENTAGE","CA WORKERS COMP WC06","CA WORKERS COMPENSATION"],"accepts":null,"setting":null},"status":"inferred","source":"anthem-tic-2026-10","asOf":"2026-10-01","checkedAt":"2026-10-22T17:01:10Z","staleAfter":"2027-03-30","confidence":"low","gate":"G3i","sentence":"Likely: Anthem Blue Cross's price file suggests Anthem Blue Cross pays Michael Usem, MD (NPI 1427154103) for workers' compensation (file of Oct 1, 2026). That is a lead, not a directory listing."},{"id":"ins-ahf-medi-cal","value":null,"status":"not-listed","source":"ahf-fhir-directory","asOf":"2026-09-19","checkedAt":"2026-10-22T14:57:40Z","staleAfter":"2027-03-18","confidence":"low","gate":"G3","sentence":"Not listed by AIDS Healthcare Foundation (PHP) Medi-Cal plans for Michael Usem, MD (NPI 1427154103) in AIDS Healthcare Foundation (PHP)'s directory, file of Sep 19, 2026. That is not a no.","checkedSources":[{"source":"ahf-fhir-directory","asOf":"2026-09-19"}]},{"id":"ins-ahf-medicare-advantage","value":null,"status":"not-listed","source":"ahf-fhir-directory","asOf":"2026-09-15","checkedAt":"2026-10-22T14:57:40Z","staleAfter":"2027-03-14","confidence":"low","gate":"G3","sentence":"Not listed by AIDS Healthcare Foundation (PHP) Medicare Advantage plans for Michael Usem, MD (NPI 1427154103) in AIDS Healthcare Foundation (PHP)'s directory, file of Sep 15, 2026. That is not a no.","checkedSources":[{"source":"ahf-fhir-directory","asOf":"2026-09-15"}]},{"id":"ins-bsc-medi-cal","value":null,"status":"not-listed","source":"bsc-fhir-directory","asOf":"2026-10-22","checkedAt":"2026-10-22T16:50:39Z","staleAfter":"2027-04-20","confidence":"low","gate":"G3","sentence":"Not listed by Blue Shield of California Promise Health Plan Medi-Cal plans for Michael Usem, MD (NPI 1427154103) in Blue Shield of California's directory, file of Oct 22, 2026. That is not a no.","checkedSources":[{"source":"bsc-fhir-directory","asOf":"2026-10-22"}]},{"id":"ins-bsc-medicare-advantage","value":null,"status":"not-listed","source":"bsc-fhir-directory","asOf":"2026-10-22","checkedAt":"2026-10-22T16:50:39Z","staleAfter":"2027-04-20","confidence":"low","gate":"G3","sentence":"Not listed by Blue Shield of California Medicare Advantage plans for Michael Usem, MD (NPI 1427154103) in Blue Shield of California's directory, file of Oct 22, 2026. That is not a no.","checkedSources":[{"source":"bsc-fhir-directory","asOf":"2026-10-22"}]},{"id":"ins-caloptima-medi-cal","value":null,"status":"not-listed","source":"caloptima-fhir-directory","asOf":"2026-10-11","checkedAt":"2026-10-22T21:38:03Z","staleAfter":"2027-04-09","confidence":"low","gate":"G3","sentence":"Not listed by CalOptima Health Medi-Cal plans for Michael Usem, MD (NPI 1427154103) in CalOptima Health's directory, file of Oct 11, 2026. That is not a no.","checkedSources":[{"source":"caloptima-fhir-directory","asOf":"2026-10-11"}]},{"id":"ins-calviva-medi-cal","value":null,"status":"not-listed","source":"healthnet-fhir-directory","asOf":"2026-10-21","checkedAt":"2026-10-22T21:25:40Z","staleAfter":"2027-04-19","confidence":"low","gate":"G3","sentence":"Not listed by CalViva Health Medi-Cal plans for Michael Usem, MD (NPI 1427154103) in Health Net's directory, file of Oct 21, 2026. That is not a no.","checkedSources":[{"source":"healthnet-fhir-directory","asOf":"2026-10-21"}]},{"id":"ins-ccah-medi-cal","value":null,"status":"not-listed","source":"ccah-fhir-directory","asOf":"2026-10-22","checkedAt":"2026-10-22T14:57:43Z","staleAfter":"2027-04-20","confidence":"low","gate":"G3","sentence":"Not listed by Central California Alliance for Health Medi-Cal plans for Michael Usem, MD (NPI 1427154103) in Central California Alliance for Health's directory, file of Oct 22, 2026. That is not a no.","checkedSources":[{"source":"ccah-fhir-directory","asOf":"2026-10-22"}]},{"id":"ins-goldcoast-medi-cal","value":null,"status":"not-listed","source":"goldcoast-fhir-directory","asOf":"2026-10-09","checkedAt":"2026-10-22T14:57:24Z","staleAfter":"2027-04-07","confidence":"low","gate":"G3","sentence":"Not listed by Gold Coast Health Plan Medi-Cal plans for Michael Usem, MD (NPI 1427154103) in Gold Coast Health Plan's directory, file of Oct 9, 2026. That is not a no.","checkedSources":[{"source":"goldcoast-fhir-directory","asOf":"2026-10-09"}]},{"id":"ins-healthnet-marketplace","value":null,"status":"not-listed","source":"healthnet-fhir-directory","asOf":"2026-10-22","checkedAt":"2026-10-22T21:25:40Z","staleAfter":"2027-04-20","confidence":"low","gate":"G3","sentence":"Not listed by Ambetter from Health Net individual and family plans for Michael Usem, MD (NPI 1427154103) in Health Net's directory, file of Oct 22, 2026. That is not a no.","checkedSources":[{"source":"healthnet-fhir-directory","asOf":"2026-10-22"}]},{"id":"ins-healthnet-medi-cal","value":null,"status":"not-listed","source":"healthnet-fhir-directory","asOf":"2026-10-22","checkedAt":"2026-10-22T21:25:40Z","staleAfter":"2027-04-20","confidence":"low","gate":"G3","sentence":"Not listed by Health Net Medi-Cal plans for Michael Usem, MD (NPI 1427154103) in Health Net's directory, file of Oct 22, 2026. That is not a no.","checkedSources":[{"source":"healthnet-fhir-directory","asOf":"2026-10-22"}]},{"id":"ins-healthnet-medicare-advantage","value":null,"status":"not-listed","source":"healthnet-fhir-directory","asOf":"2026-10-22","checkedAt":"2026-10-22T21:25:40Z","staleAfter":"2027-04-20","confidence":"low","gate":"G3","sentence":"Not listed by Wellcare by Health Net Medicare Advantage plans for Michael Usem, MD (NPI 1427154103) in Health Net's directory, file of Oct 22, 2026. That is not a no.","checkedSources":[{"source":"healthnet-fhir-directory","asOf":"2026-10-22"}]},{"id":"ins-hpsj-medi-cal","value":null,"status":"not-listed","source":"hpsj-fhir-directory","asOf":"2026-10-02","checkedAt":"2026-10-22T21:41:38Z","staleAfter":"2027-03-31","confidence":"low","gate":"G3","sentence":"Not listed by Health Plan of San Joaquin Medi-Cal plans for Michael Usem, MD (NPI 1427154103) in Health Plan of San Joaquin's directory, file of Oct 2, 2026. That is not a no.","checkedSources":[{"source":"hpsj-fhir-directory","asOf":"2026-10-02"}]},{"id":"ins-iehp-marketplace","value":null,"status":"not-listed","source":"iehp-fhir-directory","asOf":"2026-07-27","checkedAt":"2026-10-22T15:10:17Z","staleAfter":"2027-01-23","confidence":"low","gate":"G3","sentence":"Not listed by Inland Empire Health Plan (IEHP) individual and family plans for Michael Usem, MD (NPI 1427154103) in Inland Empire Health Plan (IEHP)'s directory, file of Jul 27, 2026. That is not a no.","checkedSources":[{"source":"iehp-fhir-directory","asOf":"2026-07-27"}]},{"id":"ins-iehp-medi-cal","value":null,"status":"not-listed","source":"iehp-fhir-directory","asOf":"2026-07-29","checkedAt":"2026-10-22T15:10:17Z","staleAfter":"2027-01-25","confidence":"low","gate":"G3","sentence":"Not listed by Inland Empire Health Plan (IEHP) Medi-Cal plans for Michael Usem, MD (NPI 1427154103) in Inland Empire Health Plan (IEHP)'s directory, file of Jul 29, 2026. That is not a no.","checkedSources":[{"source":"iehp-fhir-directory","asOf":"2026-07-29"}]},{"id":"ins-iehp-medicare-advantage","value":null,"status":"not-listed","source":"iehp-fhir-directory","asOf":"2026-10-16","checkedAt":"2026-10-22T15:10:17Z","staleAfter":"2027-04-14","confidence":"low","gate":"G3","sentence":"Not listed by Inland Empire Health Plan (IEHP) Medicare Advantage plans for Michael Usem, MD (NPI 1427154103) in Inland Empire Health Plan (IEHP)'s directory, file of Oct 16, 2026. That is not a no.","checkedSources":[{"source":"iehp-fhir-directory","asOf":"2026-10-16"}]},{"id":"ins-kern-medi-cal","value":null,"status":"not-listed","source":"kern-fhir-directory","asOf":"2026-10-09","checkedAt":"2026-10-22T15:04:08Z","staleAfter":"2027-04-07","confidence":"low","gate":"G3","sentence":"Not listed by Kern Family Health Care Medi-Cal plans for Michael Usem, MD (NPI 1427154103) in Kern Family Health Care's directory, file of Oct 9, 2026. That is not a no.","checkedSources":[{"source":"kern-fhir-directory","asOf":"2026-10-09"}]},{"id":"ins-lacare-medi-cal","value":null,"status":"not-listed","source":"lacare-fhir-directory","asOf":"2026-10-19","checkedAt":"2026-10-22T15:06:55Z","staleAfter":"2027-04-17","confidence":"low","gate":"G3","sentence":"Not listed by L.A. Care Health Plan Medi-Cal plans for Michael Usem, MD (NPI 1427154103) in L.A. Care Health Plan's directory, file of Oct 19, 2026. That is not a no.","checkedSources":[{"source":"lacare-fhir-directory","asOf":"2026-10-19"}]},{"id":"ins-medicare-medicare","value":null,"status":"not-listed","source":"cms-medicare-clinicians","asOf":"2026-10-02","checkedAt":"2026-10-22T14:36:32Z","staleAfter":"2027-01-30","confidence":"low","gate":"G3","sentence":"Not listed by Original Medicare for Michael Usem, MD (NPI 1427154103) in CMS Medicare clinicians file, file of Oct 2, 2026. That is not a no.","checkedSources":[{"source":"cms-medicare-clinicians","asOf":"2026-10-02"}]},{"id":"ins-optum-medicare-advantage","value":null,"status":"not-listed","source":"uhc-fhir-directory","asOf":"2026-10-23","checkedAt":"2026-10-23T17:42:33Z","staleAfter":"2027-04-21","confidence":"low","gate":"G3","sentence":"Not listed by Optum Behavioral Health Medicare Advantage plans for Michael Usem, MD (NPI 1427154103) in UnitedHealthcare's directory, file of Oct 23, 2026. That is not a no.","checkedSources":[{"source":"uhc-fhir-directory","asOf":"2026-10-23"}]},{"id":"ins-partnership-medi-cal","value":null,"status":"not-listed","source":"partnership-fhir-directory","asOf":"2026-10-16","checkedAt":"2026-10-22T21:38:25Z","staleAfter":"2027-04-14","confidence":"low","gate":"G3","sentence":"Not listed by Partnership HealthPlan of California Medi-Cal plans for Michael Usem, MD (NPI 1427154103) in Partnership HealthPlan of California's directory, file of Oct 16, 2026. That is not a no.","checkedSources":[{"source":"partnership-fhir-directory","asOf":"2026-10-16"}]},{"id":"ins-sfhp-medi-cal","value":null,"status":"not-listed","source":"sfhp-fhir-directory","asOf":"2026-10-01","checkedAt":"2026-10-22T14:56:20Z","staleAfter":"2027-03-30","confidence":"low","gate":"G3","sentence":"Not listed by San Francisco Health Plan Medi-Cal plans for Michael Usem, MD (NPI 1427154103) in San Francisco Health Plan's directory, file of Oct 1, 2026. That is not a no.","checkedSources":[{"source":"sfhp-fhir-directory","asOf":"2026-10-01"}]},{"id":"ins-uhc-marketplace","value":null,"status":"not-listed","source":"uhc-fhir-directory","asOf":"2026-10-23","checkedAt":"2026-10-23T17:42:33Z","staleAfter":"2027-04-21","confidence":"low","gate":"G3","sentence":"Not listed by UnitedHealthcare individual and family plans for Michael Usem, MD (NPI 1427154103) in UnitedHealthcare's directory, file of Oct 23, 2026. That is not a no.","checkedSources":[{"source":"uhc-fhir-directory","asOf":"2026-10-23"}]},{"id":"ins-uhc-medi-cal","value":null,"status":"not-listed","source":"uhc-fhir-directory","asOf":"2026-10-23","checkedAt":"2026-10-23T17:42:33Z","staleAfter":"2027-04-21","confidence":"low","gate":"G3","sentence":"Not listed by UnitedHealthcare Medi-Cal plans for Michael Usem, MD (NPI 1427154103) in UnitedHealthcare's directory, file of Oct 23, 2026. That is not a no.","checkedSources":[{"source":"uhc-fhir-directory","asOf":"2026-10-23"}]},{"id":"ins-va-va","value":null,"status":"not-listed","source":"uhc-fhir-directory","asOf":"2026-10-23","checkedAt":"2026-10-23T17:42:33Z","staleAfter":"2027-04-21","confidence":"low","gate":"G3","sentence":"Not listed by VA Community Care for Michael Usem, MD (NPI 1427154103) in UnitedHealthcare's directory, file of Oct 23, 2026. That is not a no.","checkedSources":[{"source":"uhc-fhir-directory","asOf":"2026-10-23"},{"source":"va-ccn-vagov-locator-2026-10","asOf":"2026-10-22"}]}],"coverage":{"state":"CA","covered":true,"checkedAt":"2026-10-23T22:13:50Z"}},"publicRecord":{},"claim":{"claimed":false,"identityConfirmedOn":null},"actions":{"call":"tel:+15104331040","book":null,"payDoor":null,"saveContact":"/npi/1427154103.vcf","intent":null},"hiddenFacts":[],"answers":[{"q":"new-patients","status":"confirmed","answer":"Cigna's directory listed Michael Usem, MD (NPI 1427154103) as taking new patients on Sep 20, 2026.","factIds":["new-patients"]},{"q":"insurance","status":"confirmed","answer":"Listed for Michael Usem, MD (NPI 1427154103): Alameda Alliance for Health, Medi-Cal (Apr 21, 2026); Blue Shield of California, commercial (Oct 22, 2026); Blue Shield of California, individual and family (Oct 22, 2026); Cigna / Evernorth, commercial (Sep 20, 2026); Health Net, commercial (Oct 19, 2026); and 3 more on the page. Each listing names its source and date.","factIds":["ins-alameda-medi-cal","ins-bsc-commercial","ins-bsc-marketplace","ins-cigna-commercial","ins-healthnet-commercial","ins-medi-cal-ffs-medi-cal","ins-uhc-commercial","ins-uhc-medicare-advantage"]},{"q":"cost","status":"unknown","answer":"Gale has no record of what a first visit with Michael Usem, MD (NPI 1427154103) costs. Paying yourself? You can ask for a written Good Faith Estimate before the visit.","factIds":[]},{"q":"video","status":"confirmed","answer":"DHCS Medi-Cal plan network listing listed Michael Usem, MD (NPI 1427154103) for video and in-person visits on Apr 21, 2026. The state file is old; Gale found no newer one.","factIds":["video"]},{"q":"where","status":"self-reported","answer":"Michael Usem, MD (NPI 1427154103) is listed in Oakland, CA by the NPPES registry, as of the registry file of Jun 8, 2026.","factIds":["city","state"]},{"q":"who-they-see","status":"unknown","answer":"Gale has no record of who Michael Usem, MD (NPI 1427154103) sees. Ask the office.","factIds":[]},{"q":"help-with","status":"unknown","answer":"Gale has no record of what Michael Usem, MD (NPI 1427154103) helps with beyond the registry specialty. Ask the office.","factIds":[]},{"q":"languages","status":"unknown","answer":"Gale has no record of the languages Michael Usem, MD (NPI 1427154103) speaks. Ask the office.","factIds":[]},{"q":"how-to-book","status":"self-reported","answer":"Call (510) 433-1040, the practice phone the NPPES registry lists for Michael Usem, MD (NPI 1427154103) (Jun 8, 2026).","factIds":["phone"]},{"q":"next-opening","status":"unknown","answer":"Gale has no record of the next opening for Michael Usem, MD (NPI 1427154103). Ask the office.","factIds":[]}],"sources":[{"id":"nppes-registry","name":"NPPES registry (CMS)","kind":"registry","asserting":true,"fileDate":"2026-06-08","url":"https://npiregistry.cms.hhs.gov/provider-view/1427154103","handCheck":null},{"id":"aetna-tic-2026-10","name":"Aetna's price file","kind":"price-file","asserting":false,"fileDate":"2026-10-05","url":null,"handCheck":{"wrong":3,"checked":12,"at":"2026-10-22"}},{"id":"ahf-fhir-directory","name":"AIDS Healthcare Foundation (PHP)'s directory","kind":"directory","asserting":true,"fileDate":"2026-09-19","url":null,"handCheck":null},{"id":"anthem-tic-2026-10","name":"Anthem Blue Cross's price file","kind":"price-file","asserting":false,"fileDate":"2026-10-01","url":null,"handCheck":{"wrong":8,"checked":11,"at":"2026-10-22"}},{"id":"bsc-fhir-directory","name":"Blue Shield of California's directory","kind":"directory","asserting":true,"fileDate":"2026-10-22","url":null,"handCheck":{"wrong":23,"checked":60,"at":"2026-10-22"}},{"id":"caloptima-fhir-directory","name":"CalOptima Health's directory","kind":"directory","asserting":true,"fileDate":"2026-10-11","url":null,"handCheck":{"wrong":4,"checked":12,"at":"2026-10-22"}},{"id":"ccah-fhir-directory","name":"Central California Alliance for Health's directory","kind":"directory","asserting":true,"fileDate":"2026-10-22","url":null,"handCheck":null},{"id":"cigna-fhir-directory","name":"Cigna's directory","kind":"directory","asserting":false,"fileDate":"2026-10-22","url":null,"handCheck":{"wrong":3,"checked":51,"at":"2026-10-22"}},{"id":"cms-medicare-clinicians","name":"CMS Medicare clinicians file","kind":"cms-file","asserting":true,"fileDate":"2026-10-02","url":null,"handCheck":{"wrong":0,"checked":23,"at":"2026-10-22"}},{"id":"dhcs-ffs-enrolled-2026-10-19","name":"DHCS Medi-Cal fee-for-service enrolment file","kind":"state-file","asserting":true,"fileDate":"2026-10-19","url":null,"handCheck":null},{"id":"dhcs-mcp-274-listing","name":"DHCS Medi-Cal plan network listing","kind":"state-file","asserting":true,"fileDate":"2026-04-21","url":null,"handCheck":null},{"id":"goldcoast-fhir-directory","name":"Gold Coast Health Plan's directory","kind":"directory","asserting":true,"fileDate":"2026-10-09","url":null,"handCheck":null},{"id":"healthnet-fhir-directory","name":"Health Net's directory","kind":"directory","asserting":true,"fileDate":"2026-10-22","url":null,"handCheck":{"wrong":6,"checked":12,"at":"2026-10-22"}},{"id":"hpsj-fhir-directory","name":"Health Plan of San Joaquin's directory","kind":"directory","asserting":true,"fileDate":"2026-10-02","url":null,"handCheck":null},{"id":"iehp-fhir-directory","name":"Inland Empire Health Plan (IEHP)'s directory","kind":"directory","asserting":true,"fileDate":"2026-10-16","url":null,"handCheck":{"wrong":4,"checked":12,"at":"2026-10-22"}},{"id":"kern-fhir-directory","name":"Kern Family Health Care's directory","kind":"directory","asserting":true,"fileDate":"2026-10-09","url":null,"handCheck":null},{"id":"lacare-fhir-directory","name":"L.A. Care Health Plan's directory","kind":"directory","asserting":true,"fileDate":"2026-10-19","url":null,"handCheck":{"wrong":4,"checked":12,"at":"2026-10-22"}},{"id":"partnership-fhir-directory","name":"Partnership HealthPlan of California's directory","kind":"directory","asserting":true,"fileDate":"2026-10-16","url":null,"handCheck":null},{"id":"sfhp-fhir-directory","name":"San Francisco Health Plan's directory","kind":"directory","asserting":true,"fileDate":"2026-10-01","url":null,"handCheck":null},{"id":"uhc-fhir-directory","name":"UnitedHealthcare's directory","kind":"directory","asserting":true,"fileDate":"2026-10-23","url":null,"handCheck":{"wrong":6,"checked":12,"at":"2026-10-22"}},{"id":"va-ccn-vagov-locator-2026-10","name":"VA's community care locator","kind":"directory","asserting":true,"fileDate":"2026-10-22","url":null,"handCheck":null}],"terms":"https://www.gale.care/agents#terms","about":{"status":"How each fact is known. confirmed = Listed: a named directory, CMS file or state file lists it. inferred = Likely: a price file suggests it; a likely match is a lead, not a listing. self-reported: the clinician said it, to the NPPES registry or on Gale. not-listed: a source that lists every clinician it covers was read and does not list this one; that is not a no. unknown: no record; ask the office.","sentence":"The fact in one sentence that names the clinician, the NPI, the source and the date. It starts with the status word. Quote it whole.","asOf":"The date the source gives this record (YYYY-MM-DD). It is not the date of the event the record describes: an opt-out states its own start and end dates in its sentence.","checkedAt":"When Gale last read the source.","staleAfter":"After this date the fact keeps its status word and date, and staleNote says the record is old; later still it is dropped. A fact from a full CMS or state file the publisher has not replaced stays, marked stale, for as long as that file is the newest one, and its staleNote says Gale found no newer file.","staleNote":"On a fact past its fresh window only: the record's age, as its own sentence (\"The state file is old; Gale found no newer one.\"). It never changes the status.","confidence":"How far Gale trusts the source, measured on the source (high, medium, low, none). Never a judgment of the clinician.","cautions":"hand-check: Gale checked a sample of this source by hand and found errors (sources[].handCheck has the numbers). conflict: another source disagrees (see conflict). stale: the record is past its fresh window. A caution never changes the status.","gate":"The publication switch that lets this kind of fact show. It says nothing about the clinician.","checkedSources":"For a not-listed fact: each source that was read, with its date.","insurance.rows[].value":"payer is a short id for the plan and payerLabel its name. line is the kind of plan: commercial, marketplace (individual and family), medicare, medicare-advantage, medi-cal, tricare, va, workers-comp. accepts is true on a listing and false only on a dated refusal (a directory's \"not accepting\" or an opt-out), never from absence; on a lead (status inferred) it is null, because a price file never says a clinician accepts a plan. optOut, on an Original Medicare opt-out, is the opt-out's own start and end dates (from, to) from CMS's opt-out list. setting is where the listing says care happens (office, virtual, both), or null when the source does not say.","insurance.coverage":"covered: whether Gale read the insurance files for this state; checkedAt: when it last did.","sources[].kind":"registry: the NPPES registry. cms-file, state-file: government files. directory: an insurer's directory. price-file: an insurer's published rates, which give leads only. gale: Gale's booking system. clinician: the clinician on Gale.","sources[].fileDate":"The date of the source file Gale read.","sources[].handCheck":"Gale's hand check of the source: checked is how many of its entries Gale checked by hand, wrong how many of those were wrong, at the date of the check. It describes the source, not this clinician.","sources[].asserting":"true when the source lists every clinician it covers, so its silence can support a not-listed fact. Only such sources ever do.","factsHash":"Changes only when a fact changes, never on a re-check.","index.basis":"Why the page is or is not indexed. index-all: indexed. Anything else: not indexed, and no reason about the clinician is given.","exportId":"The data export the facts come from.","hiddenFacts":"Facts withheld because someone disputed them. No reason is given."}}