Individual provider Active NPI

Tina Marie Buoncristiani, P.N.P.

  • Pediatric Nurse Practitioner
  • Mill Valley, CA
National Provider Identifier
1063744753
Registry record updated Feb 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
11100 Issued in CA
Practice address
402 Molino Ave
Mill Valley, CA 94941-3337
Phone
(415) 888-2568
NPI assigned
Feb 4, 2010
Last updated
Feb 4, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 11100 CA Primary

Addresses

Primary practice location

402 Molino Ave
Mill Valley, CA 94941-3337

Mailing address

505 Parnassus Ave
San Francisco, CA 94143-2204
Phone (415) 353-1978

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110707000676 CA Practitioner - Nurse Practitioner 6103004593 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
UCSF Pediatrics Associates CurrentSince May 23, 2011 Accepting new patients

Locations

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

3333 California St
San Francisco, CA 94118
Phone (415) 514-3577

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

Interoperability endpoints

  • Direct secure messaging: tbuoncristiani15094@direct-ucsfmedicalcenter.org

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1265241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265241600000",
    "number": "1063744753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 PARNASSUS AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432204",
            "telephone_number": "415-353-1978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 MOLINO AVE",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949413337",
            "telephone_number": "415-888-2568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUONCRISTIANI",
        "first_name": "TINA",
        "middle_name": "MARIE",
        "credential": "P.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-04",
        "last_updated": "2010-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "11100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mill Valley, CA

Sources for this page

Verify at the official NPI Registry.