Individual provider Active NPI

Paul David Kretkowski, MPAS, PA-C

  • Physician Assistant
  • San Francisco, CA
National Provider Identifier
1215561006
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
57988 Issued in CA
Practice address
170 Columbus Ave Ste 110
San Francisco, CA 94133-5160
Phone
(415) 965-8050
Fax
(415) 965-7678
NPI assigned
Mar 2, 2020
Last updated
Jan 5, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 57988 CA Primary

Addresses

Primary practice location

170 Columbus Ave Ste 110
San Francisco, CA 94133-5160

Mailing address

3400 Data Dr
Rancho Cordova, CA 95670-7956

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231005003712 CA Practitioner - Physician Assistant 8123430444 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
UCSF Health Medical FoundationGroup PAC ID 9436239878, 65 clinicians

Practice addresses (Care Compare)

170 Columbus Ave
Suite 110
San Francisco, CA 94133-5160
Phone (415) 965-8050

199 W Portal Ave
San Francisco, CA 94127-1305
Phone (415) 821-8798

2288 Market St
San Francisco, CA 94114-1506
Phone (415) 964-4855

2395 Lombard St
San Francisco, CA 94123-2601
Phone (415) 796-2242

2895 Diamond St
San Francisco, CA 94131-3004
Phone (415) 964-4866

3838 California St
RM 111
San Francisco, CA 94118-1504
Phone (415) 221-6476

3900 Piedmont Ave
Oakland, CA 94611-5352
Phone (415) 432-7899

750 Redwood Hwy Frontage Rd
Suite 1204
Mill Valley, CA 94941-2483
Phone (415) 384-4778

Merit-based Incentive Payment System (MIPS)

Final score
99.64 of 100Reported as apm
Quality
86.27
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
88.91 of 100Reported as group
Quality
94.45
Improvement activities
40
Cost
70.44

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
57988CAMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: pkretkowski154675@uihcdirect.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, 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": "1583107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1215561006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 COLUMBUS AVE STE 110",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941335160",
            "telephone_number": "415-965-8050",
            "fax_number": "415-965-7678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRETKOWSKI",
        "first_name": "PAUL",
        "middle_name": "DAVID",
        "credential": "MPAS, PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-02",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "57988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.