Individual provider Active NPI

Oliver Cervantes

  • Pediatrics Physician
  • San Francisco, CA
National Provider Identifier
1164043170
Registry record updated Jun 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A189854 Issued in CA
Practice address
1001 Potrero Ave. BLDG. 5, #6M
San Francisco, CA 94110
Phone
(628) 206-8376
Fax
(628) 206-7506
NPI assigned
Apr 30, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2025

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
Pediatrics Physician 208000000X A189854 CA Primary

Addresses

Primary practice location

1001 Potrero Ave. BLDG. 5, #6M
San Francisco, CA 94110

Mailing address

1450 6TH Ave
San Francisco, CA 94122-3811
Phone (973) 452-5654

Other practice location 1

1450 6th Ave
San Francisco, CA 94122-3811
Phone (973) 452-5654

Other practice location 2

550 6th Ave Fl 4
San Francisco, CA 94118-3817
Phone (973) 452-5654

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
I20250702004165 CA Practitioner - Pediatric Medicine 6507395969 Reassigns benefits to 5 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A189854CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
UCSF Medical Group Business Services CurrentSince Jun 17, 2025 Accepting new patients
University of California SFGH Medical Group Current Accepting new patients
University of California SFGH Medical Group CurrentSince Jul 14, 2025 Accepting new patients
City & County of San Francisco Current Accepting new patients
UCSF Medical Group Business Services CurrentSince Jun 17, 2025 Accepting new patients
City & County of San Francisco CurrentSince Jul 14, 2025 Accepting new patients
University of California SFGH Medical Group CurrentSince Jul 14, 2025 Accepting new patients
University of California San Francisco CurrentSince Jun 17, 2025 Accepting new patients
University of California San Francisco Pediatrics CurrentSince Jun 17, 2025 Accepting new patients
UCSF Pediatrics Associates Pediatrics CurrentSince Jun 17, 2025 Accepting new patients
City and County of San Francisco CurrentSince Jul 14, 2025 Accepting new patients
University of California San Francisco Medical Center Past Accepting new patients

Locations

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

1001 Potrero Ave
Rm 5H22
San Francisco, CA 94110
Phone (628) 206-4774

1001 Potrero Ave
Bldg 5
San Francisco, CA 94110
Phone (628) 206-5753

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

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

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

1001 Potrero Ave
Ste 7M8
San Francisco, CA 94110
Phone (415) 206-3325

550 16th St
Fl 4
San Francisco, CA 94143
Phone (415) 476-5001

Organizations & group practices 12

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": "1588204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750377600000",
    "number": "1164043170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 6TH AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941223811",
            "telephone_number": "973-452-5654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 POTRERO AVE. BLDG. 5, #6M",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94110",
            "telephone_number": "628-206-8376",
            "fax_number": "628-206-7506"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1450 6th Ave",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941223811",
            "country_code": "US",
            "telephone_number": "973-452-5654",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "550 6th Ave Fl 4",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941183817",
            "country_code": "US",
            "telephone_number": "973-452-5654",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CERVANTES",
        "first_name": "OLIVER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-30",
        "last_updated": "2025-06-20",
        "certification_date": "2025-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A189854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.