Individual provider Active NPI

Sara Moschetto, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Greenbrae, CA
National Provider Identifier
1083058192
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95007576 Issued in CA
Practice address
250 Bon Air Rd Unit B
Greenbrae, CA 94904-1702
Phone
(415) 473-6835
NPI assigned
Apr 18, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Registered Nurse 163W00000X 830350 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95007576 CA Primary

Addresses

Primary practice location

250 Bon Air Rd Unit B
Greenbrae, CA 94904-1702

Mailing address

250 Bon Air Rd Unit B
Greenbrae, CA 94904-1702
Phone (415) 473-6835

Other practice location 1

52 Dore St
San Francisco, CA 94103-3828
Phone (415) 553-3100

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
I20181126000752 CA Practitioner - Nurse Practitioner 4880948199 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
County of MarinGroup PAC ID 1153225065, 19 clinicians

Practice addresses (Care Compare)

250 Bon Air Rd
Greenbrae, CA 94904-1702
Phone (415) 499-6835

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
830350CAMDRegistered Nurse
95007576CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
County of Marin CurrentSince Sep 1, 2018 Accepting new patients
County of Marin CurrentSince Sep 1, 2018 Accepting new patients

Locations

250 Bon Air Rd
Kentfield, CA 94904
Phone (415) 464-1350

Organizations & group practices 2

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": "1366243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1083058192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 BON AIR RD UNIT B",
            "city": "GREENBRAE",
            "state": "CA",
            "postal_code": "949041702",
            "telephone_number": "415-473-6835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 BON AIR RD UNIT B",
            "city": "GREENBRAE",
            "state": "CA",
            "postal_code": "949041702",
            "telephone_number": "415-473-6835"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "52 Dore St",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941033828",
            "country_code": "US",
            "telephone_number": "415-553-3100",
            "fax_number": "415-553-3119",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOSCHETTO",
        "first_name": "SARA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-18",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "830350",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95007576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenbrae, CA

Sources for this page

Verify at the official NPI Registry.