Individual provider Active NPI

Laura K. Pak, M.D.

  • Vascular Surgery Physician
  • Greenbrae, CA
National Provider Identifier
1194715912
Registry record updated Aug 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
A60365 Issued in CA
Practice address
1100 S Eliseo Dr
Suite 2a
Greenbrae, CA 94904-2017
Phone
(415) 464-5400
Fax
(415) 464-5413
NPI assigned
Oct 24, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X A60365 CA Primary

Addresses

Primary practice location

1100 S Eliseo Dr
Suite 2a
Greenbrae, CA 94904-2017

Mailing address

1100 S Eliseo Dr
Suite 2a
Greenbrae, CA 94904-2017
Phone (415) 464-5400

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
I20101111001444 CA Practitioner - Vascular Surgery 6103713219 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Perelman School of Med at the University of Pennsylvania, 1993
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

  • Marinhealth Medical Center Hospital, Greenbrae, CA, CCN 050360

Merit-based Incentive Payment System (MIPS)

Final score
91.9 of 100Reported as group
Quality
81.89
Promoting interoperability
99
Improvement activities
40

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
Spinal fusion60
Varicose vein removal35
Leg revascularization (restoring blood flow)1-10
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Regents Univ of California UCSF CurrentSince Jan 1, 2019 Accepting new patients
University of California San Francisco Past Accepting new patients
Providence Health & Services - Wa Past Accepting new patients
Sutter Bay Hospitals Past Accepting new patients
Sonoma Valley Health Care District Past Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients
Marin General Hospital Past Accepting new patients
Providence Health System - Southern California Past Accepting new patients

Locations

1100 S Eliseo Dr
Greenbrae, CA 94904
Phone (415) 461-3200

1100 S Eliseo Dr
Ste 2A
Greenbrae, CA 94904
Phone (415) 464-5400

2 Bon Air Rd
Ste 100
Larkspur, CA 94939

75 Rowland Way
Ste 131
Novato, CA 94945
Phone (415) 464-5400

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

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

651 1st St W
Ste H
Sonoma, CA 95476
Phone (707) 938-3870

Interoperability endpoints

  • Direct secure messaging: lpak103674@direct-ucsfmedicalcenter.org

Organizations & group practices 8

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": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375660800000",
    "number": "1194715912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 S ELISEO DR",
            "address_2": "SUITE 2A",
            "city": "GREENBRAE",
            "state": "CA",
            "postal_code": "949042017",
            "telephone_number": "415-464-5400",
            "fax_number": "415-464-5413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S ELISEO DR",
            "address_2": "SUITE 2A",
            "city": "GREENBRAE",
            "state": "CA",
            "postal_code": "949042017",
            "telephone_number": "415-464-5400",
            "fax_number": "415-464-5413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAK",
        "first_name": "LAURA",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-24",
        "last_updated": "2013-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "CA",
            "license": "A60365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenbrae, CA

Sources for this page

Verify at the official NPI Registry.