Individual provider Active NPI

Anna Kristina Paulsson, M.D.

  • Radiation Oncology Physician
  • San Francisco, CA
National Provider Identifier
1134562333
Registry record updated May 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
A136094 Issued in CA
Practice address
1600 Divisadero St
Suite H1031
San Francisco, CA 94143
Phone
(415) 353-7175
NPI assigned
Apr 8, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2018

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
Radiation Oncology Physician 2085R0001X A136094 CA Primary

Addresses

Primary practice location

1600 Divisadero St
Suite H1031
San Francisco, CA 94143

Mailing address

1600 Divisadero St
Suite H1031
San Francisco, CA 94143-1708

Other practice location 1

110 Lynch Creek Way Ste A
Petaluma, CA 94954-2337
Phone (707) 763-0600

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
I20180823002445 CA Practitioner - Radiation Oncology 1355634510 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

110 Lynch Creek Way
Suite a
Petaluma, CA 94954-2337
Phone (707) 763-0600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
136094CAMDMarriage & Family Therapist
A136094CAMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince Jul 23, 2018 Accepting new patients
Providence Medical Foundation CurrentSince Jul 23, 2018 Accepting new patients
Providence Medical Foundation Current Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients
Providence Medical Foundation Past Accepting new patients

Locations

200 W Ctr St Promenade
Ste 300
Anaheim, CA 92805
Phone (714) 449-4841

110 Lynch Creek Way
#A
Petaluma, CA 94954
Phone (707) 763-0600

3555 Round Barn Cir
Santa Rosa, CA 95403
Phone (707) 528-1050

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

500 Doyle Park Dr
Ste 100
Santa Rosa, CA 95405
Phone (714) 449-4842

Interoperability endpoints

  • Direct secure messaging: anna.paulsson@stjoe.direct.varian.com
  • Direct secure messaging: apaulsson1658151@oc.providencedirect.org

Organizations & group practices 5

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 3

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": "1365379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526601600000",
    "number": "1134562333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 DIVISADERO ST",
            "address_2": "SUITE H1031",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941431708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 DIVISADERO ST",
            "address_2": "SUITE H1031",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94143",
            "telephone_number": "415-353-7175"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Lynch Creek Way Ste A",
            "address_purpose": "LOCATION",
            "city": "Petaluma",
            "state": "CA",
            "postal_code": "949542337",
            "country_code": "US",
            "telephone_number": "707-763-0600",
            "fax_number": "707-765-1757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAULSSON",
        "first_name": "ANNA",
        "middle_name": "KRISTINA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-08",
        "last_updated": "2018-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "CA",
            "license": "A136094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.