NPIMap

Organization Active NPI

Bay Area Rehabilitation Medical Group

  • Physical Medicine & Rehabilitation Physician
  • San Francisco, CA
National Provider Identifier
1396748935
Registry record updated Feb 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
G817050 Issued in CA
Legal business name
BAY AREA REHABILITATION MEDICAL GROUP
Practice address
2250 Hayes St
San Francisco, CA 94117-1013
Phone
(415) 750-5761
Fax
(415) 666-0210
NPI assigned
May 27, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2008

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

Authorized official

Name
Kenneth Fechtner, M.D.
Title
Partner
Phone
(415) 750-5761

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X G817050 CA Primary

Addresses

Primary practice location

2250 Hayes St
San Francisco, CA 94117-1013

Mailing address

2250 Hayes St
San Francisco, CA 94117-1013
Phone (415) 750-5761

Other identifiers 8

IdentifierTypeStateIssuer
ZZZ14205ZOtherCAGROUP LEGACY
GR0008972MedicaidCA
GR0008971MedicaidCA
ZZZ00551ZOtherCAGROUP LEGACY
GR0008970MedicaidCA
ZZZ00899ZOtherCAGROUP LEGACY
CP1128OtherCAGROUP MCRERR
GR0008973MedicaidCA

National Provider Directory

National Provider Directory

Locations

2250 Hayes St
San Francisco, CA 94117
Phone (415) 750-5761

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201824000000",
    "number": "1396748935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 HAYES ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941171013",
            "telephone_number": "415-750-5761",
            "fax_number": "415-666-0210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 HAYES ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941171013",
            "telephone_number": "415-750-5761",
            "fax_number": "415-666-0210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAY AREA REHABILITATION MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-27",
        "last_updated": "2008-02-01",
        "status": "A",
        "authorized_official_last_name": "FECHTNER",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "415-750-5761",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "G817050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP LEGACY",
            "identifier": "ZZZ14205Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0008972",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0008971",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP LEGACY",
            "identifier": "ZZZ00551Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0008970",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP LEGACY",
            "identifier": "ZZZ00899Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MCRERR",
            "identifier": "CP1128",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0008973",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "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 Feb 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.