Individual provider Active NPI

Debra Dasaro St Claire, M.D.

  • Internal Medicine Physician
  • Menlo Park, CA
National Provider Identifier
1205974409
Registry record updated Apr 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G76348 Issued in CA
Practice address
925 Hamilton Ave
Menlo Park, CA 94025-1431
Phone
(650) 521-0444
NPI assigned
Feb 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G76348 CA Primary

Addresses

Primary practice location

925 Hamilton Ave
Menlo Park, CA 94025-1431

Mailing address

925 Hamilton Ave
Menlo Park, CA 94025-1431
Phone (650) 521-5440

Other identifiers 1

IdentifierTypeStateIssuer
G76348OtherCASTATE LICENSE

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
I20230131002384 CA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 2365514023

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G76348CAMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: debra.claire@49412312072196.direct.elationemr.com
  • Direct secure messaging: debra.dasarostclaire@1384432730116.direct.elationemr.com

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522713600000",
    "number": "1205974409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 HAMILTON AVE",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940251431",
            "telephone_number": "650-521-5440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 HAMILTON AVE",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940251431",
            "telephone_number": "650-521-0444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST CLAIRE",
        "first_name": "DEBRA",
        "middle_name": "DASARO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2018-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G76348",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "G76348",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Menlo Park, CA

Sources for this page

Verify at the official NPI Registry.