Individual provider Active NPI

Peter Alexander Ljubenkov, M.D.

  • Neurology Physician
  • San Francisco, CA
National Provider Identifier
1316238850
Registry record updated Aug 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
A124893 Issued in CA
Practice address
675 Nelson Rising LN Ste 190
San Francisco, CA 94143-0003
Phone
(415) 353-2057
NPI assigned
May 2, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2022

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
Neurology Physician 2084N0400X A124893 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
Phone (415) 353-2057

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
I20150709002370 CA Practitioner - Neurology 9537471164 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Temple University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
UCSF Medical Group Business ServicesGroup PAC ID 3779497870, 1,533 clinicians

Practice addresses (Care Compare)

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

400 Parnassus Ave
San Francisco, CA 94143-2202
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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
124893CAMDMarriage & Family Therapist
A124893CAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of California San Francisco Current Accepting new patients
University of California San Francisco Neurology CurrentSince Jul 1, 2015 Accepting new patients
UCSF Medical Group Business Services CurrentSince Jul 1, 2015 Accepting new patients
University of California San Francisco CurrentSince Jul 1, 2015 Accepting new patients
UCSF Medical Group Business Services Neurology CurrentSince Jul 1, 2015 Accepting new patients
University of California - Irvine Medical Center Past Accepting new patients
University of California San Francisco Medical Center Past Accepting new patients
University of California San Francisco Past Accepting new patients

Locations

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

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

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

400 Parnassus Ave
San Francisco, CA 94143
Phone (415) 353-2000

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

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

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

Interoperability endpoints

  • Direct secure messaging: pljubenkov72731@direct-ucsfmedicalcenter.org

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 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": "1304294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1316238850",
    "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",
            "telephone_number": "415-353-2057"
        },
        {
            "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": "415-353-2057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LJUBENKOV",
        "first_name": "PETER",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-02",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A124893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.