Individual provider Active NPI

Mia Michelle Ma

  • Diagnostic Radiology Physician
  • San Francisco, CA
National Provider Identifier
1316527062
Registry record updated Jul 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A206454 Issued in CA
Practice address
505 Parnassus Ave
San Francisco, CA 94143-2204
Phone
(415) 353-9056
NPI assigned
Apr 8, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X A206454 CA Primary

Addresses

Primary practice location

505 Parnassus Ave
San Francisco, CA 94143-2204

Mailing address

1001 Potrero Ave
BLDG. 5, 1St Floor
San Francisco, CA 94110-3518
Phone (628) 206-8020

Other practice location 1

1001 Potrero Ave
Bldg. 5, 1st Floor
San Francisco, CA 94110-3510
Phone (628) 206-8020

Other practice location 2

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (248) 770-6989

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
I20260421002151 CA Practitioner - Diagnostic Radiology 2860897071 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Wayne State University School of Medicine, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2001 The Embarcadero
Suite 1500
San Francisco, CA 94143-5200

2001 The Embarcadero St
Suite 1500
San Francisco, CA 94133-2964

2799 W Grand Blvd
Detroit, MI 48202-2608

PO Box
Los Angeles, CA 90074

Hospital & facility affiliations

  • UCSF Medical Center Hospital, San Francisco, CA, CCN 050454

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A206454CAMDDiagnostic Radiology Physician

Interoperability endpoints

  • Direct secure messaging: mma639985@direct.hfhs.org

Organizations & group practices 2

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": "1617840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785196800000",
    "number": "1316527062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 POTRERO AVE",
            "address_2": "BLDG. 5, 1ST FLOOR",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941103518",
            "telephone_number": "628-206-8020",
            "fax_number": "628-206-4004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 PARNASSUS AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432204",
            "telephone_number": "415-353-9056"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 Potrero Ave",
            "address_2": "Bldg. 5, 1st Floor",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941103510",
            "country_code": "US",
            "telephone_number": "628-206-8020",
            "fax_number": "628-206-4004",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2799 W Grand Blvd",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482022608",
            "country_code": "US",
            "telephone_number": "248-770-6989",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MA",
        "first_name": "MIA",
        "middle_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-08",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A206454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.