NPIMap

Individual provider Active NPI

Nivedita Poola, MD

  • Emergency Medicine Physician
  • San Francisco, CA
National Provider Identifier
1245859909
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A194558 Issued in CA
Practice address
521 Parnassus Ave # 7319
San Francisco, CA 94143-2206
Phone
(415) 353-1595
NPI assigned
Apr 13, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X A194558 CA Primary

Addresses

Primary practice location

521 Parnassus Ave # 7319
San Francisco, CA 94143-2206

Mailing address

450 Clarkson Ave
Brooklyn, NY 11203-2012
Phone (718) 270-6315

Other practice location 1

450 Clarkson Ave
Brooklyn, NY 11203-2012
Phone (718) 270-6315 ext. 4577

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240618002569 CA Practitioner - Emergency Medicine 7416490461 Reassigns benefits to 2 organizations
I20251230000688 TX Practitioner - Emergency Medicine 7416490461 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Boston University School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of California SFGH Medical GroupGroup PAC ID 5496668410, 566 clinicians

Practice addresses (Care Compare)

1001 Potrero Ave
San Francisco, CA 94110-3518
Phone (628) 206-5753

Hospital & facility affiliations

  • Zuckerberg San Francisco General Hosp & Trauma Ctr Hospital, San Francisco, CA, CCN 050228
  • San Carlos Apache Healthcare Corporation Hospital, Peridot, AZ, CCN 031320

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of California SFGH Medical Group Current Accepting new patients
City and County of San Francisco CurrentSince Jul 15, 2024 Accepting new patients
University of California SFGH Medical Group CurrentSince Jul 1, 2024 Accepting new patients
San Carlos Apache Healthcare Corporation CurrentSince Nov 26, 2025 Accepting new patients
City & County of San Francisco Current Accepting new patients
University of California SFGH Medical Group Emergency Medicine CurrentSince Jul 1, 2024 Accepting new patients
City & County of San Francisco CurrentSince Jul 15, 2024 Accepting new patients

Locations

103 Medicine Way Rd
Peridot, AZ 85542
Phone (928) 475-1200

1001 Potrero Ave
San Francisco, CA 94110
Phone (415) 206-2305

1001 Potrero Ave
Bldg 5
San Francisco, CA 94110
Phone (628) 206-5753

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 4

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": "1586736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713312000000",
    "number": "1245859909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 CLARKSON AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032012",
            "telephone_number": "718-270-6315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 PARNASSUS AVE # 7319",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432206",
            "telephone_number": "415-353-1595"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "450 Clarkson Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112032012",
            "country_code": "US",
            "telephone_number": "718-270-6315 x4577",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POOLA",
        "first_name": "NIVEDITA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-13",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A194558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.