Individual provider Active NPI

Dora Anna Rendulic Storelli, MD

  • Student in an Organized Health Care Education/Training Program
  • San Francisco, CA
National Provider Identifier
1104058072
Registry record updated Jan 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
500 Parnassus Ave # Mu320-W
San Francisco, CA 94143-2203
Phone
(415) 514-3288
NPI assigned
Aug 11, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Hand Surgery Physician 207XS0106X MD182410 OR
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

500 Parnassus Ave # Mu320-W
San Francisco, CA 94143-2203

Mailing address

5050 NE Hoyt St Ste 340
Portland, OR 97213-2983
Phone (503) 467-7090

Other practice location 1

5050 NE Hoyt St Ste 340
Portland, OR 97213-2983
Phone (503) 467-7090

Other identifiers 1

IdentifierTypeStateIssuer
500725220MedicaidOR

Other names 1

  • Dora Anna Rendulic Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

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
I20221128003001 CA Practitioner - Orthopedic Surgery 2264710227 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of California, Davis School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

6600 Bruceville Rd
Sacramento, CA 95823-4671
Phone (916) 688-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD182410ORMDOrthopaedic Hand Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc CurrentSince Aug 16, 2022 Accepting new patients
Permanente Medical Group, Inc CurrentSince Aug 16, 2022 Accepting new patients
Permanente Medical Group Inc Current Accepting new patients
Orthopedic Specialists, PC Current Accepting new patients

Locations

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

1800 Harrison St
Fl 7
Oakland, CA 94612

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

501 J St
Sacramento, CA 95814
Phone (916) 497-3000

6600 Bruceville Rd
Sacramento, CA 95823

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834

5050 NE Hoyt St
Ste 340
Portland, OR 97213
Phone (503) 234-9861

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1249948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1104058072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5050 NE HOYT ST STE 340",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132983",
            "telephone_number": "503-467-7090",
            "fax_number": "503-546-7240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 PARNASSUS AVE # MU320-W",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432203",
            "telephone_number": "415-514-3288"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5050 NE Hoyt St Ste 340",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972132983",
            "country_code": "US",
            "telephone_number": "503-467-7090",
            "fax_number": "503-546-7240",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STORELLI",
        "first_name": "DORA",
        "middle_name": "ANNA RENDULIC",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-11",
        "last_updated": "2022-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "OR",
            "license": "MD182410",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500725220",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "6600 Bruceville Rd",
            "city": "Sacramento",
            "state": "CA",
            "country_code": "US",
            "postal_code": "958234671",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "DORA",
            "last_name": "RENDULIC",
            "middle_name": "ANNA",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.