Individual provider Active NPI

Theodora M. Mauro, M.D.

  • Dermatology Physician
  • San Francisco, CA
National Provider Identifier
1285609040
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
G54795 Issued in CA
Practice address
4150 Clement St
San Francisco, CA 94121-1545
Phone
(415) 750-0091
NPI assigned
Feb 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X G54795 CA Primary

Addresses

Primary practice location

4150 Clement St
San Francisco, CA 94121-1545

Mailing address

PO Box 942895
Sacramento, CA 94295-0001
Phone (916) 653-0080

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080219000357 CA Practitioner - Dermatology 3971686643 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Medical College of Pennsylvania, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

400 Parnassus Ave
McB300
San Francisco, CA 94143-0810
Phone (415) 476-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
54795CAMDGeneral Practice Dentistry
G54795CAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of California San Francisco Dermatology CurrentSince Jul 1, 2007 Accepting new patients
UCSF Medical Group Business Services Dermatology CurrentSince Jul 1, 2007 Accepting new patients
UCSF Medical Group Business Services CurrentSince Jul 1, 2007 Accepting new patients
University of California San Francisco Current Accepting new patients
University of California San Francisco CurrentSince Jul 1, 2007 Accepting new patients

Locations

400 Parnassus Ave
#300
San Francisco, CA 94143
Phone (415) 476-2163

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

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

1701 Divisadero St
Fl 3
San Francisco, CA 94115
Phone (415) 353-7800

4150 Clement St
San Francisco, CA 94121
Phone (415) 750-2110

1701 Divisadero St
San Francisco, CA 94115
Phone (415) 353-7300

1600 Divisadero St
San Francisco, CA 94143
Phone (415) 353-7175

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

Organizations & group practices 5

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 1

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": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285609040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 942895",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "942950001",
            "telephone_number": "916-653-0080",
            "fax_number": "916-653-1795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 CLEMENT ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941211545",
            "telephone_number": "415-750-0091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAURO",
        "first_name": "THEODORA",
        "middle_name": "M.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "G54795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.