NPIMap

Organization Active NPI

University of California SFGH Medical Group

Doing business as UCSF SFGH Medical Group Dept of Family Practice

  • Family Medicine Physician
  • San Francisco, CA
National Provider Identifier
1174598296
Registry record updated Dec 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
UNIVERSITY OF CALIFORNIA SFGH MEDICAL GROUP
Doing business as
UCSF SFGH Medical Group Dept of Family Practice
Practice address
1001 Potrero Ave
BLDG 80 Ward 83 RM 320
San Francisco, CA 94110-3518
Phone
(628) 206-8610
Fax
(628) 206-8387
NPI assigned
Feb 22, 2006
Last updated
Dec 23, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2025

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

Authorized official

Name
Juanita Villanueva
Title
Director
Phone
(415) 514-2574

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

1001 Potrero Ave
BLDG 80 Ward 83 RM 320
San Francisco, CA 94110-3518

Mailing address

PO Box 743749
Los Angeles, CA 90074-3749
Phone (415) 514-3000

Other identifiers 1

IdentifierTypeStateIssuer
ZZZP3885ZMedicaidCA

Other names 1

  • UCSF SFGH Medical Group Dept of Family Practice Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Bluemark LLC / Office Ally

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031112000551 CA Part B Supplier - Clinic/Group Practice 5496668410 Receives reassigned benefits from 818 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: San Francisco, CA; San Franciso, CA

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
SFGH Medical Group43 organizations share this tax ID, including this one

Other organizations with this tax ID 42

Organizations that report the same tax identification number in the National Provider Directory.

View all 42

Practitioners & affiliated clinicians

Practitioners 138

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 138

NPI Registry JSON

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766448000000",
    "number": "1174598296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743749",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900743749",
            "telephone_number": "415-514-3000",
            "fax_number": "415-502-8175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 POTRERO AVE",
            "address_2": "BLDG 80 WARD 83 RM 320",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941103518",
            "telephone_number": "628-206-8610",
            "fax_number": "628-206-8387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF CALIFORNIA SFGH MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-22",
        "last_updated": "2025-12-23",
        "certification_date": "2025-12-23",
        "status": "A",
        "authorized_official_last_name": "VILLANUEVA",
        "authorized_official_first_name": "JUANITA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "415-514-2574"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZP3885Z",
            "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 SFGH Medical Group Dept of Family Practice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "UCSF SFGH Medical Group Dept of Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.