UCSF Department of Pediatrics

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

220000091 Issued in CA

Legal business name

UCSF DEPARTMENT OF PEDIATRICS

Practice address

400 Parnassus Ave
San Francisco, CA 94143-2202

Phone

(415) 476-1000

Fax

(415) 476-4150

NPI assigned

Jun 23, 2010

Organization subpart

Yes

Parent organization

UCSF MEDICAL CENTERAs reported in NPPES

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

Authorized official

Name

Mr. David Rein

Title

Cfo

Phone

(415) 476-4003

Specialties & licenses 3

Addresses

Electronic endpoints 1

Tax ID family

Bluemark LLC Office Ally3 organizations share this tax ID, including this one

Part of

UCSF Department of Pedi

Other organizations with this tax ID 2

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

• Pediatric Associates

  • Physician Assistant
  • San Francisco, CA
  • NPI 1366735581
  NPD tax ID
• UCSF Pediatric Associates

  • Children's Hospital
  • San Francisco, CA
  • NPI 1457604498
  NPD tax ID

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

{
    "created_epoch": "1277251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744761600000",
    "number": "1174834337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 DIVISADERO ST",
            "address_2": "STE 625",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941431821",
            "telephone_number": "415-476-4029",
            "fax_number": "415-476-4150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 PARNASSUS AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432202",
            "telephone_number": "415-476-1000",
            "fax_number": "415-476-4150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UCSF DEPARTMENT OF PEDIATRICS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UCSF MEDICAL CENTER",
        "enumeration_date": "2010-06-23",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A",
        "authorized_official_last_name": "REIN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "415-476-4003",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "220000091",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "220000091",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "220000091",
            "primary": true
        }
    ],
    "identifiers": [],
    "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": []
}

• UCSF Department of Anesthesia
• UCSF Department of Laboratory Medicine
• UCSF Department of Laboratory Medicine
• UCSF Department of Laboratory Medicine
• UCSF Department of Pediatrics
• UCSF Department of Surgery
• UCSF Department of Surgery
• UCSF Dept of Surgery
• UCSF Dermatopathology Service
• UCSF Division of Orthodontics

• Pediatric Nurse Practitioner in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Pediatric Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.