Individual provider Active NPI

William C. Mentzer, M.D.

  • Pediatric Hematology & Oncology Physician
  • San Francisco, CA
National Provider Identifier
1255430146
Registry record updated Aug 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X
License
G11921 Issued in CA
Practice address
505 Parnassus Ave # M649
San Francisco, CA 94143-2204
Phone
(415) 476-1280
Fax
(415) 502-4372
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X G11921 CA
Pediatric Hematology & Oncology Physician 2080P0207X G11921 CA Primary

Addresses

Primary practice location

505 Parnassus Ave # M649
San Francisco, CA 94143-2204

Mailing address

1635 Divisadero St
Suite 625, Box 1821
San Francisco, CA 94143-0001
Phone (415) 476-4029

Other identifiers 1

IdentifierTypeStateIssuer
00G119210MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G11921CAMDPediatric Hematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of California San Francisco Medical Center Past Accepting new patients
University of California San Francisco Past Accepting new patients
UCSF Medical Center at Mt. Zion Past Accepting new patients
UCSF Pediatrics Associates Pediatrics Past Accepting new patients

Organizations & group practices 4

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345766400000",
    "number": "1255430146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 DIVISADERO ST",
            "address_2": "SUITE 625, BOX 1821",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941430001",
            "telephone_number": "415-476-4029",
            "fax_number": "415-476-4150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 PARNASSUS AVE # M649",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432204",
            "telephone_number": "415-476-1280",
            "fax_number": "415-502-4372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENTZER",
        "first_name": "WILLIAM",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2012-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G11921",
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "CA",
            "license": "G11921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G119210",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.