Individual provider Active NPI

Jennifer Emily Mustard, PA

  • Medical Physician Assistant
  • Oakland, CA
National Provider Identifier
1063960268
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA60336 Issued in CA
Practice address
744 52ND St Ste 4100
Oakland, CA 94609-1810
Phone
(510) 428-3022
NPI assigned
Sep 15, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA188794 OR
Medical Physician Assistant 363AM0700X PA188794 OR
Medical Physician Assistant 363AM0700X PA60336 CA Primary

Addresses

Primary practice location

744 52ND St Ste 4100
Oakland, CA 94609-1810

Mailing address

744 52ND St Ste 4100
Oakland, CA 94609-1810
Phone (510) 428-3022

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
I20241022005202 CA Practitioner - Physician Assistant 1951645001 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA188794ORMDPhysician Assistant
PA60336CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of California San Francisco CurrentSince Aug 17, 2024 Accepting new patients
UCSF Medical Group Business Services CurrentSince Aug 17, 2024 Accepting new patients
University of California San Francisco Medical Center Past Accepting new patients
University of California San Francisco Past Accepting new patients

Locations

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

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

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

Interoperability endpoints

  • Direct secure messaging: jmustard307637@direct-ucsfmedicalcenter.org

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": "1473897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1063960268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 52ND ST STE 4100",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946091810",
            "telephone_number": "510-428-3022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 52ND ST STE 4100",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946091810",
            "telephone_number": "510-428-3022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSTARD",
        "first_name": "JENNIFER",
        "middle_name": "EMILY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-15",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA188794",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA188794",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA60336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.