NPIMap

Individual provider Active NPI

Elisa Frances Raquidan Nasol, MD

  • Family Medicine Physician
  • Daly City, CA
National Provider Identifier
1154754539
Registry record updated Jan 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A164838 Issued in CA
Practice address
380 90TH St
Daly City, CA 94015-1807
Phone
(650) 301-8600
NPI assigned
Aug 20, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A164838 CA Primary

Addresses

Primary practice location

380 90TH St
Daly City, CA 94015-1807

Mailing address

380 90TH St
Daly City, CA 94015-1807

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
I20220214002153 CA Practitioner - General Practice 6709279813 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Oregon Health Sciences University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of San MateoGroup PAC ID 9032023171, shared by 15 NPIs, 316 clinicians

Practice addresses (Care Compare)

222 W 39TH Ave
San Mateo, CA 94403-4364
Phone (650) 573-2222

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A164838CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Mateo CurrentSince Nov 2, 2021 Accepting new patients
County of San Mateo Current Accepting new patients
County of San Mateo CurrentSince Nov 2, 2021 Accepting new patients
County of San Mateo CurrentSince Nov 2, 2021 Accepting new patients

Locations

380 90th St
Daly City, CA 94015
Phone (650) 301-8600

222 W 39th Ave
San Mateo, CA 94403
Phone (415) 573-2222

Interoperability endpoints

  • Direct secure messaging: enasol19166@smch.direct-ci.com

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 10

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": "1376956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642723200000",
    "number": "1154754539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 90TH ST",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940151807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 90TH ST",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940151807",
            "telephone_number": "650-301-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASOL",
        "first_name": "ELISA FRANCES",
        "middle_name": "RAQUIDAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-20",
        "last_updated": "2022-01-21",
        "certification_date": "2022-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A164838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daly City, CA

Sources for this page

Verify at the official NPI Registry.