NPIMap

Organization Active NPI

Pacific Heights Medical Group

  • Internal Medicine Physician
  • San Francisco, CA
National Provider Identifier
1376693200
Registry record updated Dec 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PACIFIC HEIGHTS MEDICAL GROUP
Practice address
2340 Clay St
Sixth Floor
San Francisco, CA 94115-1932
Phone
(415) 674-5223
Fax
(415) 600-3705
NPI assigned
Jan 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2022

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

Authorized official

Name
Anita Nicholas Demas, MDNPI 1174646012
Title
Partner
Phone
(415) 674-5223

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

2340 Clay St
Sixth Floor
San Francisco, CA 94115-1932

Mailing address

2340 Clay St FL 6
San Francisco, CA 94115-1932
Phone (415) 674-5200

Other identifiers 1

IdentifierTypeStateIssuer
YYY49305YMedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Athena

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040416000453 CA Part B Supplier - Clinic/Group Practice 8224023593 Receives reassigned benefits from 13 practitioners
Practice locations: San Francisco, CA

National Provider Directory

National Provider Directory
Tax ID family
Pacific Heights Medical Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

2340 Clay St
Fl Sixth
San Francisco, CA 94115
Phone (415) 600-3700

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23254/brand/2/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 19

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

View all 19

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669852800000",
    "number": "1376693200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2340 CLAY ST FL 6",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941151932",
            "telephone_number": "415-674-5200",
            "fax_number": "415-600-3705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2340 CLAY ST",
            "address_2": "SIXTH FLOOR",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941151932",
            "telephone_number": "415-674-5223",
            "fax_number": "415-600-3705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC HEIGHTS MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A",
        "authorized_official_last_name": "DEMAS",
        "authorized_official_first_name": "ANITA",
        "authorized_official_middle_name": "NICHOLAS",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "415-674-5223",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "YYY49305Y",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Athena",
            "affiliation": "N",
            "endpointDescription": "Athena",
            "address_1": "2340 Clay St",
            "address_2": "Sixth Floor",
            "city": "San Francisco",
            "state": "CA",
            "country_code": "US",
            "postal_code": "941151932",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.