Individual provider Active NPI

Gary M. Sanchez, PA-C

  • Physician Assistant
  • Greenbrae, CA
National Provider Identifier
1386658318
Registry record updated Mar 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA14454 Issued in CA
Practice address
1100 S Eliseo Dr Ste 1
Greenbrae, CA 94904-2017
Phone
(415) 514-6868
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA14454 CA Primary

Addresses

Primary practice location

1100 S Eliseo Dr Ste 1
Greenbrae, CA 94904-2017

Mailing address

1441 Florida Ave
Modesto, CA 95350-4404
Phone (209) 576-3601

Other practice location 1

99 Montecillo Rd
San Rafael, CA 94903-3308
Phone (415) 444-2560

Other identifiers 1

IdentifierTypeStateIssuer
CD069AOtherCAGROUP MEDICARE #

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120131000319 CA Practitioner - Physician Assistant 6305818949 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA14454CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of California San Francisco CurrentSince Feb 13, 2023 Accepting new patients
UCSF Medical Group Business Services CurrentSince Feb 13, 2023 Accepting new patients
University of California San Francisco CurrentSince Feb 13, 2023 Accepting new patients

Locations

3100 San Pablo Ave
Berkeley, CA 94702
Phone (510) 985-5020

1100 S Eliseo Dr
Ste 1
Greenbrae, CA 94904
Phone (415) 514-5000

1441 Florida Ave
Modesto, CA 95350
Phone (209) 214-7235

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

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

2001 The Embarcadero
Ste 1500
San Francisco, CA 94143
Phone (415) 353-1606

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

99 Montecillo Rd
San Rafael, CA 94903
Phone (415) 444-2047

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678406400000",
    "number": "1386658318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 FLORIDA AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504404",
            "telephone_number": "209-576-3601",
            "fax_number": "209-576-3680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S ELISEO DR STE 1",
            "city": "GREENBRAE",
            "state": "CA",
            "postal_code": "949042017",
            "telephone_number": "415-514-6868"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "99 Montecillo Rd",
            "address_purpose": "LOCATION",
            "city": "San Rafael",
            "state": "CA",
            "postal_code": "949033308",
            "country_code": "US",
            "telephone_number": "415-444-2560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANCHEZ",
        "first_name": "GARY",
        "middle_name": "M.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2023-03-10",
        "certification_date": "2023-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA14454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE #",
            "identifier": "CD069A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenbrae, CA

Sources for this page

Verify at the official NPI Registry.