Individual provider Active NPI

Shamiq Zackria, MD

  • Hospitalist Physician
  • San Francisco, CA
National Provider Identifier
1396188181
Registry record updated Feb 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
A141301 Issued in CA
Practice address
1100 Van Ness Ave
San Francisco, CA 94109-6978
Phone
(415) 600-3548
Fax
(415) 558-7020
NPI assigned
Apr 10, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A141301 CA
Hepatology Physician 207RI0008X A141301 CA
Hospitalist Physician 208M00000X A141301 CA Primary

Addresses

Primary practice location

1100 Van Ness Ave
San Francisco, CA 94109-6978

Mailing address

325 Distel Cir
Los Altos, CA 94022-1408
Phone (415) 600-3458

Other identifiers 1

IdentifierTypeStateIssuer
A141301OtherCASTATE MEDICAL LICENSE

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160610001822 CA Practitioner - HospitalistPractitioner - Internal Medicine 1153631361 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

1100 Van Ness Ave
San Francisco, CA 94109-6978
Phone (415) 600-0140

1101 Van Ness Ave
San Francisco, CA 94109-6919
Phone (415) 600-6000

3838 California St
San Francisco, CA 94118-1506

795 El Camino Real
Palo Alto, CA 94301-2302
Phone (415) 600-1020

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation CurrentSince Aug 1, 2017 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Aug 1, 2017 Accepting new patients
Sutter Bay Hospitals Past Accepting new patients

Locations

1950 University Ave
Ste 160
East Palo Alto, CA 94303
Phone (650) 317-8100

325 Distel Cir
Los Altos, CA 94022
Phone (510) 204-3977

2350 W El Camino Real
Fl 2
Mountain View, CA 94040
Phone (650) 691-6174

795 El Camino Real
#1112
Palo Alto, CA 94301

151 N Sunrise Ave
Ste 1205
Roseville, CA 95661
Phone (916) 789-1505

3838 California St
Rm 404
San Francisco, CA 94118
Phone (415) 600-0940

1100 Van Ness Ave
Fl 3
San Francisco, CA 94109
Phone (415) 600-3397

2340 Clay St
Fl 2
San Francisco, CA 94115
Phone (415) 600-3458

3838 California St
Rm 410
San Francisco, CA 94118
Phone (415) 751-1847

1100 Van Ness Ave
San Francisco, CA 94109
Phone (415) 600-5760

Interoperability endpoints

  • Direct secure messaging: szackria343486@hisp.ehr.sutterhealth.org

Organizations & group practices 3

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": "1365552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582761600000",
    "number": "1396188181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408",
            "telephone_number": "415-600-3458",
            "fax_number": "415-558-7020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 VAN NESS AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941096978",
            "telephone_number": "415-600-3548",
            "fax_number": "415-558-7020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZACKRIA",
        "first_name": "SHAMIQ",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-10",
        "last_updated": "2020-02-27",
        "certification_date": "2020-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A141301",
            "primary": false
        },
        {
            "code": "207RI0008X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hepatology",
            "state": "CA",
            "license": "A141301",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A141301",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "A141301",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.