NPIMap

University of California SFGH Medical Group

Organization Active NPI Infectious Disease Physician · San Francisco, CA

NPI 1366417933 · NPPES record last updated Dec 23, 2025

Key facts

NPI
1366417933
Entity type
Organization (NPI type 2)
Primary specialty
Infectious Disease Physician 207RI0200X
Legal business name
UNIVERSITY OF CALIFORNIA SFGH MEDICAL GROUP
Practice address
1001 Potrero Avenue
BLDG 80 6TH Floor
San Francisco, CA 94110-3518
Phone
(628) 206-2403
Fax
(628) 206-3335
NPI assigned
Feb 17, 2006
Organization subpart
No

Authorized official

Name
Juanita Villanueva
Title
Director
Phone
(415) 514-2574

Other NPIs with the same Medicare PAC ID 13

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 42

Organizations that report the same tax identification number in the National Provider Directory.

View all 42

Practitioners 587

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

View all 587

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20050401000123 CA Part B Supplier - Clinic/Group Practice 5496668410 Receives reassigned benefits from 47 practitioners
Practice locations: San Francisco, CA

National Provider Directory

Tax ID family
SFGH Medical Group (43 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 207RI0200X Yes

Addresses

Primary practice location

1001 Potrero Avenue
BLDG 80 6TH Floor
San Francisco, CA 94110-3518

Mailing address

PO Box 743749
Los Angeles, CA 90074-3749
Phone (415) 514-3000

Other identifiers

IdentifierTypeStateIssuer
GR0062256MedicaidCA

Other names

  • UCSF SFGH Medical Group Dept of Infectious Disease Doing business as

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Bluemark LLC / Office Ally

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 23, 2025.

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766448000000",
    "number": "1366417933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743749",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900743749",
            "telephone_number": "415-514-3000",
            "fax_number": "415-502-8175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 POTRERO AVENUE",
            "address_2": "BLDG 80 6TH FLOOR",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941103518",
            "telephone_number": "628-206-2403",
            "fax_number": "628-206-3335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF CALIFORNIA SFGH MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-17",
        "last_updated": "2025-12-23",
        "certification_date": "2025-12-23",
        "status": "A",
        "authorized_official_last_name": "VILLANUEVA",
        "authorized_official_first_name": "JUANITA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "415-514-2574"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0062256",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.3",
            "affiliationName": "Bluemark LLC / Office Ally",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "1300 SE Cardinal Ct Ste 190",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986839683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "UCSF SFGH Medical Group Dept of Infectious Disease",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Francisco, CA

All providers in San Francisco, CA · Infectious Disease Physician in California

Sources for this page

Verify at the official NPI Registry.