NPIMap

Individual provider Active NPI

Nicole M Newhauser, PA

  • Surgical Physician Assistant
  • San Rafael, CA
National Provider Identifier
1124190004
Registry record updated Oct 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA16057 Issued in CA
Practice address
4000 Civic Center Dr Ste 209
San Rafael, CA 94903-5233
Phone
(415) 925-8963
NPI assigned
Nov 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA16057 CA
Surgical Physician Assistant 363AS0400X PA16057 CA Primary

Addresses

Primary practice location

4000 Civic Center Dr Ste 209
San Rafael, CA 94903-5233

Mailing address

2100 Powell St
Suite 900
Emeryville, CA 94608-1826
Phone (510) 350-2673

Other practice location 1

250 Bon Air Rd
Greenbrae, CA 94904-1702
Phone (415) 925-7200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060120000591 CA Practitioner - Physician Assistant 4486678182 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of California San FranciscoGroup PAC ID 4486567229, 1,780 clinicians
UCSF Medical Group Business ServicesGroup PAC ID 3779497870, 1,533 clinicians

Practice addresses (Care Compare)

2330 Post St
San Francisco, CA 94115-3465
Phone (415) 476-4029

400 Parnassus Ave
San Francisco, CA 94143-2202

Hospital & facility affiliations

  • UCSF Medical Center Hospital, San Francisco, CA, CCN 050454
  • Providence Santa Rosa Memorial Hospital Hospital, Santa Rosa, CA, CCN 050174
  • John Muir Medical Center - Walnut Creek Campus Hospital, Walnut Creek, CA, CCN 050180
  • Marinhealth Medical Center Hospital, Greenbrae, CA, CCN 050360
  • Providence Queen of the Valley Medical Center Hospital, Napa, CA, CCN 050009

Merit-based Incentive Payment System (MIPS)

Final score
81.03 of 100Reported as subgroup
Quality
80.86
Promoting interoperability
76
Improvement activities
40
Cost
75.91

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA16057CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of California San Francisco CurrentSince Oct 1, 2020 Accepting new patients
UCSF Medical Group Business Services CurrentSince Oct 1, 2020 Accepting new patients
University of California San Francisco CurrentSince Oct 1, 2020 Accepting new patients
Marin General Hospital Past Accepting new patients
University of California San Francisco Past Accepting new patients
Central Dupage Physician Group Past Accepting new patients
University of California San Francisco Medical Center Past Accepting new patients

Locations

225 California Dr
Burlingame, CA 94010
Phone (415) 353-2002

1240 S Eliseo Dr
Ste 101
Greenbrae, CA 94904
Phone (415) 592-2014

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

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

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

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

4000 Civic Center Dr
Ste 209
San Rafael, CA 94903
Phone (415) 492-4840

Interoperability endpoints

  • Direct secure messaging: nnewhauser129539@direct-ucsfmedicalcenter.org

Organizations & group practices 11

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 6

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": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1124190004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 POWELL ST",
            "address_2": "SUITE 900",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081826",
            "telephone_number": "510-350-2673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 CIVIC CENTER DR STE 209",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949035233",
            "telephone_number": "415-925-8963"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "250 Bon Air Rd",
            "address_purpose": "LOCATION",
            "city": "Greenbrae",
            "state": "CA",
            "postal_code": "949041702",
            "country_code": "US",
            "telephone_number": "415-925-7200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEWHAUSER",
        "first_name": "NICOLE",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA16057",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA16057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

Verify at the official NPI Registry.