University of California San Francisco Medical Center

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

220000091 Issued in CA

Legal business name

UNIVERSITY OF CALIFORNIA SAN FRANCISCO MEDICAL CENTER

Practice address

400 Parnassus Ave
750 A
San Francisco, CA 94122-2721

Phone

(415) 353-2800

Fax

(415) 353-2564

NPI assigned

Nov 6, 2006

Organization subpart

Yes

Parent organization

UNIVERSITY OF CALIFORNIA, SAN FRANCISCOAs reported in NPPES

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

Authorized official

Name

Mr. Jed Shivers

Title

Coo

Phone

(415) 476-4003

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• UCSF Ophthalmology Group Doing business as

Electronic endpoints 1

Part of

UCSF Department of Pedi

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744675200000",
    "number": "1104995364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 DIVISADERO ST",
            "address_2": "SUITE 625, BOX 1821",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941430001",
            "telephone_number": "415-476-4029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 PARNASSUS AVE",
            "address_2": "750 A",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941222721",
            "telephone_number": "415-353-2800",
            "fax_number": "415-353-2564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF CALIFORNIA SAN FRANCISCO MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNIVERSITY OF CALIFORNIA, SAN FRANCISCO",
        "enumeration_date": "2006-11-06",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A",
        "authorized_official_last_name": "SHIVERS",
        "authorized_official_first_name": "JED",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "415-476-4003",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "220000091",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0084292",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.3",
            "affiliationName": "Bluemark LLC / Office Ally",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "1300 SE Cardinal Ct Ste 190",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986839683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "UCSF Ophthalmology Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• University of California San Francisco Medical Center
• University of California San Francisco Medical Center
• University of California San Francisco Medical Center
• University of California San Francisco Medical Center
• University of California San Francisco Medical Center
• University of California San Francisco Medical Center
• University of California San Francisco Medical Center
• University of California San Francisco Medical Center
• University of California San Francisco Medical Center
• University of California San Francisco Medical Center

• All providers in San Francisco, CA
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.