NPIMap

Individual provider Active NPI

Ian Mathias Jaffee, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • San Francisco, CA
National Provider Identifier
1376603399
Registry record updated Apr 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
A93612 Issued in CA
Practice address
3700 California St
Department of Pathology, 4TH Floor
San Francisco, CA 94118-1618
Phone
(559) 455-4000
Fax
(559) 455-4007
NPI assigned
Dec 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X A93612 CA Primary

Addresses

Primary practice location

3700 California St
Department of Pathology, 4TH Floor
San Francisco, CA 94118-1618

Mailing address

PO Box 26060
Fresno, CA 93729-6060
Phone (559) 455-4000

Other identifiers 1

IdentifierTypeStateIssuer
00A936120MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070712000820 CA Practitioner - Pathology 0648370148 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Texas Medical School at Houston, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1101 Van Ness Ave
San Francisco, CA 94109-6919
Phone (415) 600-2200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
California Pacific Pathology Medical Group Anatomic Pathology & Clinical Pathology CurrentSince Mar 2, 2014 Accepting new patients
California Pacific Pathology Medical Group Current Accepting new patients
California Pacific Pathology Medical Group CurrentSince Mar 2, 2014 Accepting new patients
California Pacific Pathology Medical Group Current Accepting new patients

Locations

5176 Hill Rd E
Lakeport, CA 95453
Phone (707) 262-5000

180 Rowland Way
Novato, CA 94945
Phone (415) 209-1300

2333 Buchanan St
San Francisco, CA 94115
Phone (415) 563-4321

1101 Van Ness Ave
San Francisco, CA 94109
Phone (415) 485-8824

3700 California St
Fl 4
San Francisco, CA 94118

3555 Cesar Chavez
San Francisco, CA 94110
Phone (415) 485-8824

601 Duboce Ave
San Francisco, CA 94117
Phone (415) 600-0600

30 Mark West Springs Rd
Santa Rosa, CA 95403
Phone (707) 576-4000

Organizations & group practices 4

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 5

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": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272240000000",
    "number": "1376603399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26060",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937296060",
            "telephone_number": "559-455-4000",
            "fax_number": "559-455-4007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 CALIFORNIA ST",
            "address_2": "DEPARTMENT OF PATHOLOGY, 4TH FLOOR",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941181618",
            "telephone_number": "559-455-4000",
            "fax_number": "559-455-4007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAFFEE",
        "first_name": "IAN",
        "middle_name": "MATHIAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2010-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "A93612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A936120",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.