Individual provider Active NPI

Alicia Lygia Callejo-Black, MD

  • Pediatrics Physician
  • San Francisco, CA
National Provider Identifier
1083291934
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
197670 Issued in CA
Practice address
2330 Post St Ste 320
San Francisco, CA 94115-3466
Phone
(415) 885-7478
NPI assigned
Mar 26, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 197670 CA Primary

Addresses

Primary practice location

2330 Post St Ste 320
San Francisco, CA 94115-3466

Mailing address

550 16TH St FL 4
San Francisco, CA 94143-2549
Phone (415) 476-9181

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
I20241007001184 CA Practitioner - Pediatric Medicine 6204367832 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
197670CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
UCSF Medical Group Business Services CurrentSince Sep 25, 2024 Accepting new patients
University of California San Francisco CurrentSince Sep 25, 2024 Accepting new patients
University of California San Francisco Pediatrics Current Accepting new patients
UCSF Pediatrics Associates Pediatrics CurrentSince Sep 25, 2024 Accepting new patients
UCSF Medical Group Business Services CurrentSince Sep 25, 2024 Accepting new patients
University of California San Francisco CurrentSince Sep 25, 2024 Accepting new patients
University of California San Francisco Medical Center Past Accepting new patients

Locations

747 52nd St
Oakland, CA 94609
Phone (510) 428-3070

747 52nd St
Ste 245
Oakland, CA 94609
Phone (510) 428-3331

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

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

1975 4th St
San Francisco, CA 94143
Phone (415) 353-3000

2330 Post St
Ste 320
San Francisco, CA 94115
Phone (415) 353-2364

550 16th St
Fl 4
San Francisco, CA 94143
Phone (415) 476-5001

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

Interoperability endpoints

  • Direct secure messaging: acallejoblack184065@direct-ucsfmedicalcenter.org

Organizations & group practices 7

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": "1616716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1083291934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 16TH ST FL 4",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432549",
            "telephone_number": "415-476-9181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 POST ST STE 320",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941153466",
            "telephone_number": "415-885-7478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLEJO-BLACK",
        "first_name": "ALICIA",
        "middle_name": "LYGIA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-26",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "197670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.