Organization Active NPI

Dominic Tse MD a Professional Corporation

  • Point of Service
  • San Francisco, CA
National Provider Identifier
1255798666
Registry record updated Jan 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Point of ServiceTaxonomy code 305S00000X
License
A32234 Issued in CA
Legal business name
DOMINIC TSE MD A PROFESSIONAL CORPORATION
Practice address
728 Pacific Ave Ste 505
San Francisco, CA 94133-4449
Phone
(415) 956-8321
Fax
(415) 393-9915
NPI assigned
Jan 15, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2016

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

Authorized official

Name
Cecilia Tse
Title
Office Manager
Phone
(415) 956-8321

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Point of Service 305S00000X A32234 CA Primary

Addresses

Primary practice location

728 Pacific Ave Ste 505
San Francisco, CA 94133-4449

Mailing address

728 Pacific Ave Ste 505
San Francisco, CA 94133-4449
Phone (415) 956-8321

Other identifiers 1

IdentifierTypeStateIssuer
00A322340OtherCAMEDICARE ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160301002085 CA Part B Supplier - Clinic/Group Practice 6901101849 Receives reassigned benefits from 1 practitioner
Practice locations: San Francisco, CA

National Provider Directory

National Provider Directory

Locations

728 Pacific Ave
Ste 505
San Francisco, CA 94133
Phone (415) 956-8321

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1452816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452816000000",
    "number": "1255798666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "728 PACIFIC AVE STE 505",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941334449",
            "telephone_number": "415-956-8321",
            "fax_number": "415-393-9915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "728 PACIFIC AVE STE 505",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941334449",
            "telephone_number": "415-956-8321",
            "fax_number": "415-393-9915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOMINIC TSE MD A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-15",
        "last_updated": "2016-01-15",
        "status": "A",
        "authorized_official_last_name": "TSE",
        "authorized_official_first_name": "CECILIA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "415-956-8321"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "CA",
            "license": "A32234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "00A322340",
            "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 Jan 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.