Individual provider Active NPI

Maude E Dull, MD

  • Pediatric Critical Care Medicine Physician
  • San Francisco, CA
National Provider Identifier
1184681603
Registry record updated Jan 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
C152808 Issued in CA
Practice address
550 16TH St FL 5
San Francisco, CA 94158-2545
Phone
(415) 476-5153
NPI assigned
Apr 27, 2006
Last updated
Jan 28, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 228170 NY
Pediatric Critical Care Medicine Physician 2080P0203X 228170 NY
Pediatric Critical Care Medicine Physician 2080P0203X C152808 CA Primary

Addresses

Primary practice location

550 16TH St FL 5
San Francisco, CA 94158-2545

Mailing address

3333 California St # S1-10
San Francisco, CA 94118-1981
Phone (415) 476-5153

Other practice location 1

245 Governors Dr SE
Huntsville, AL 35801-2700
Phone (256) 265-1000

Other identifiers 6

IdentifierTypeStateIssuer
00028182101OtherUNIVERA
071221000006OtherFIDELIS
1020856180001MedicaidPA
000529327003OtherBC/BS
02889949MedicaidNY
1214337OtherIHA

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
I20180727001570 CA Practitioner - Pediatric Medicine 7719071893 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Albany Medical College of Union University, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
UCSF Pediatrics AssociatesGroup PAC ID 6204749112, 102 clinicians

Practice addresses (Care Compare)

1975 4TH St
San Francisco, CA 94143-2351
Phone (415) 476-1000

505 Parnassus Ave
San Francisco, CA 94143-2204
Phone (415) 476-1000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C152808CAMDPediatric Critical Care Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of California San Francisco Internal Medicine CurrentSince Jun 26, 2018 Accepting new patients
UCSF Medical Group Business Services CurrentSince Jun 26, 2018 Accepting new patients
UCSF Pediatrics Associates Pediatric Critical Care Medicine CurrentSince Jun 26, 2018 Accepting new patients
UCSF Medical Group Business Services Internal Medicine CurrentSince Jun 26, 2018 Accepting new patients
University of California San Francisco CurrentSince Jun 26, 2018 Accepting new patients
University of California San Francisco Current Accepting new patients
University of California San Francisco Medical Center Past Accepting new patients
The Health Care Authority of the City of Huntsville Past Accepting new patients
University at Buffalo Pediatric Associates Inc PastSince Jan 1, 1998 Accepting new patients
University of California San Francisco Past Accepting new patients

Locations

1825 4th St
San Francisco, CA 94143
Phone (415) 353-3000

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

3333 California St
#S110
San Francisco, CA 94118
Phone (415) 514-2664

400 Parnassus Ave
San Francisco, CA 94143
Phone (415) 353-2000

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

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

550 16th St
Fl 5
San Francisco, CA 94158
Phone (415) 476-5153

Interoperability endpoints

  • Direct secure messaging: mdull98436@direct-ucsfmedicalcenter.org

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580169600000",
    "number": "1184681603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 CALIFORNIA ST # S1-10",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941181981",
            "telephone_number": "415-476-5153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 16TH ST FL 5",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941582545",
            "telephone_number": "415-476-5153"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "245 Governors Dr SE",
            "address_purpose": "LOCATION",
            "city": "Huntsville",
            "state": "AL",
            "postal_code": "358012700",
            "country_code": "US",
            "telephone_number": "256-265-1000",
            "fax_number": "256-265-7065",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DULL",
        "first_name": "MAUDE",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-27",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "228170",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "NY",
            "license": "228170",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "CA",
            "license": "C152808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00028182101",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS",
            "identifier": "071221000006",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1020856180001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "000529327003",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02889949",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHA",
            "identifier": "1214337",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.