Individual provider Active NPI

Jeremy Lacocque, DO

  • Emergency Medicine Physician
  • San Francisco, CA
National Provider Identifier
1023495504
Registry record updated Feb 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
20A17180 Issued in CA
Practice address
1001 Potrero Ave
San Francisco, CA 94110-3518
Phone
(628) 206-8000
NPI assigned
May 4, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 20A17180 CA Primary

Addresses

Primary practice location

1001 Potrero Ave
San Francisco, CA 94110-3518

Mailing address

1001 Potrero Ave
Department of Emergency Medicine, 6a
San Francisco, CA 94110
Phone (628) 206-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200310000760 CA Practitioner - Emergency Medicine 1951699461 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
97.28 of 100Reported as group
Quality
89.92
Promoting interoperability
100
Improvement activities
40
Cost
78.23

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A17180CAMDEmergency Medicine Physician
17180CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California Emergency Medicine Current Accepting new patients
University of California SFGH Medical Group Emergency Medicine CurrentSince Jul 1, 2020 Accepting new patients
Cep America - California Emergency Medicine CurrentSince Mar 16, 2020 Accepting new patients
Cep America-California Emergency Medicine CurrentSince Mar 16, 2020 Accepting new patients
University of California SFGH Medical Group Current Accepting new patients
University of California SFGH Medical Group CurrentSince Jul 1, 2020 Accepting new patients
University of California San Francisco Medical Center PastSince Mar 9, 2020 Accepting new patients
UCSF Medical Group Business Services PastSince Mar 9, 2020 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

1001 Potrero Ave
#6A
San Francisco, CA 94110

450 Stanyan St
San Francisco, CA 94117
Phone (415) 668-1000

1001 Potrero Ave
San Francisco, CA 94110
Phone (415) 206-2305

1001 Potrero Ave
Bldg 5
San Francisco, CA 94110
Phone (628) 206-5753

900 Hyde St
San Francisco, CA 94109
Phone (415) 353-6000

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1430697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582934400000",
    "number": "1023495504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 POTRERO AVE",
            "address_2": "DEPARTMENT OF EMERGENCY MEDICINE, 6A",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94110",
            "telephone_number": "628-206-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 POTRERO AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941103518",
            "telephone_number": "628-206-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACOCQUE",
        "first_name": "JEREMY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-04",
        "last_updated": "2020-02-29",
        "certification_date": "2020-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "20A17180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.