Individual provider Active NPI

Bridget Gramkowski, CPNP-PC

  • Pediatric Nurse Practitioner
  • San Francisco, CA
National Provider Identifier
1104479385
Registry record updated Jul 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
15893 Issued in CA
Practice address
1001 Potrero Ave BLDG 203
San Francisco, CA 94110-3518
Phone
(415) 254-9168
NPI assigned
Jul 17, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2019

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 15893 CA Primary

Addresses

Primary practice location

1001 Potrero Ave BLDG 203
San Francisco, CA 94110-3518

Mailing address

204 Navigator Dr
Scotts Valley, CA 95066-4064
Phone (415) 254-9168

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
I20191219000427 CA Practitioner - Nurse Practitioner 3870927163 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15893CAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
City and County of San Francisco CurrentSince Sep 28, 2019 Accepting new patients
City & County of San Francisco Current Accepting new patients
City & County of San Francisco CurrentSince Sep 28, 2019 Accepting new patients

Locations

1001 Potrero Ave
San Francisco, CA 94110
Phone (415) 206-2305

1001 Potrero Ave
Bldg 20
San Francisco, CA 94110
Phone (415) 206-8524

1001 Potrero Ave
Bldg 203
San Francisco, CA 94110
Phone (415) 254-9168

Organizations & group practices 3

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": "1563321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563321600000",
    "number": "1104479385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 NAVIGATOR DR",
            "city": "SCOTTS VALLEY",
            "state": "CA",
            "postal_code": "950664064",
            "telephone_number": "415-254-9168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 POTRERO AVE BLDG 203",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941103518",
            "telephone_number": "415-254-9168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAMKOWSKI",
        "first_name": "BRIDGET",
        "name_prefix": "Ms.",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-17",
        "last_updated": "2019-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "15893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.