Individual provider Active NPI

Elizabeth Marion Zettersten, MD

  • Specialist
  • San Rafael, CA
National Provider Identifier
1194035287
Registry record updated Oct 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A73955 Issued in CA
Practice address
5000 Civic Center Dr
San Rafael, CA 94903-4184
Phone
(415) 499-0100
NPI assigned
Oct 7, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X A73955 CA Primary

Addresses

Primary practice location

5000 Civic Center Dr
San Rafael, CA 94903-4184

Mailing address

5000 Civic Center Dr
San Rafael, CA 94903-4184
Phone (415) 499-0100

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
I20130219000215 CA Practitioner - Dermatology 0749435956 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 1991
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Regents Univ of California UCSFGroup PAC ID 6305160300, 276 clinicians

Practice addresses (Care Compare)

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

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.03 of 100Reported as subgroup
Quality
80.86
Promoting interoperability
76
Improvement activities
40
Cost
75.91

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision15
Removal of skin lesions1228
Removal or shaving of skin growth344
Skin biopsy64

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A73955CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Regents Univ of California UCSF Single Specialty CurrentSince Dec 19, 2022 Accepting new patients

Locations

599 Sir Francis Drake Blvd
Ste 300
Greenbrae, CA 94904
Phone (415) 755-4515

75 Rowland Way
Ste 101
Novato, CA 94945
Phone (415) 464-9604

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

5000 Civic Center Dr
San Rafael, CA 94903
Phone (415) 499-0100

Interoperability endpoints

  • Direct secure messaging: ezettersten268405@direct-ucsfmedicalcenter.org

Organizations & group practices 1

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 1

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": "1286409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286409600000",
    "number": "1194035287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 CIVIC CENTER DR",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949034184",
            "telephone_number": "415-499-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 CIVIC CENTER DR",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949034184",
            "telephone_number": "415-499-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZETTERSTEN",
        "first_name": "ELIZABETH",
        "middle_name": "MARION",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-07",
        "last_updated": "2010-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "A73955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

Verify at the official NPI Registry.