Individual provider Active NPI

Adam Mark Staffaroni, PHD

  • Clinical Psychologist
  • San Francisco, CA
National Provider Identifier
1245711381
Registry record updated Aug 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY30083 Issued in CA
Practice address
675 Nelson Rising LN Ste 190
San Francisco, CA 94143-0003
Phone
(415) 502-7201
NPI assigned
Aug 27, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY30083 CA Primary

Addresses

Primary practice location

675 Nelson Rising LN Ste 190
San Francisco, CA 94143-0003

Mailing address

675 Nelson Rising LN Ste 190
San Francisco, CA 94143-0003

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181204002132 CA Practitioner - Clinical Psychologist 4880938794 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2330 Post St
San Francisco, CA 94115-3465
Phone (415) 476-4029

Merit-based Incentive Payment System (MIPS)

Final score
84.89 of 100Reported as group
Quality
81.13
Improvement activities
40
Cost
71.5

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY30083CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
UCSF Medical Group Business Services CurrentSince Sep 12, 2018 Accepting new patients
University of California San Francisco CurrentSince Sep 12, 2018 Accepting new patients
University of California San Francisco Current Accepting new patients
University of California San Francisco CurrentSince Sep 12, 2018 Accepting new patients
UCSF Medical Group Business Services CurrentSince Sep 12, 2018 Accepting new patients
University of California San Francisco Medical Center Past Accepting new patients
University of California San Francisco Past Accepting new patients

Locations

675 Nelson Rising Ln
Ste 190
San Francisco, CA 94143
Phone (415) 353-2057

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

1651 4th St
Ste 212
San Francisco, CA 94158
Phone (415) 353-2057

1500 Owens St
Fl 2
San Francisco, CA 94158
Phone (415) 353-2808

1651 4th St
Fl 2
San Francisco, CA 94158
Phone (415) 353-2069

3333 California St
Ste 110
San Francisco, CA 94118

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

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1535328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535328000000",
    "number": "1245711381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 NELSON RISING LN STE 190",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941430003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 NELSON RISING LN STE 190",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941430003",
            "telephone_number": "415-502-7201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAFFARONI",
        "first_name": "ADAM",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-27",
        "last_updated": "2018-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY30083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.