NPIMap

Individual provider Active NPI

Praveen V. Mummaneni, M.D.

  • Neurological Surgery Physician
  • San Francisco, CA
National Provider Identifier
1407960099
Registry record updated Jul 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
A62374 Issued in CA
Practice address
400 Parnassus Ave
San Francisco, CA 94143-2202
Phone
(415) 885-3799
Fax
(415) 885-3864
NPI assigned
Aug 19, 2006
Last updated
Jul 22, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X A62374 CA Primary

Addresses

Primary practice location

400 Parnassus Ave
San Francisco, CA 94143-2202

Mailing address

1635 Divisadero St
Suite 625, Box 1821
San Francisco, CA 94143-0001

Other identifiers 1

IdentifierTypeStateIssuer
00A623740MedicaidCA

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
I20060929000185 CA Practitioner - Neurosurgery 7315942190 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Boston University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
UCSF Medical Group Business ServicesGroup PAC ID 3779497870, 1,533 clinicians

Practice addresses (Care Compare)

400 Parnassus Ave
San Francisco, CA 94143-2202
Phone (415) 476-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.01 of 100Reported as group
Quality
86.78
Improvement activities
40
Cost
70.46

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion384
Laminectomy or laminotomy (partial removal of spine bones)78

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
62374CAMDOrthodontics and Dentofacial Orthopedic Dentist
A62374CAMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
UCSF Medical Group Business Services CurrentSince Sep 1, 2006 Accepting new patients
UCSF Medical Group Business Services Neurological Surgery CurrentSince Sep 1, 2006 Accepting new patients
University of California SFGH Medical Group Past Accepting new patients
Arthur M. Blank Hospital, Inc. Past Accepting new patients
Crawford Long Hospital Past Accepting new patients
University of California San Francisco Medical Center Past Accepting new patients
Emory University Past Accepting new patients
University of California SFGH Medical Group Neurological Surgery PastSince Oct 1, 2013 Accepting new patients
Grady Memorial Hospital Corporation Past Accepting new patients

Locations

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

400 Parnassus Ave
San Francisco, CA 94143
Phone (415) 353-2000

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

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

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216684800000",
    "number": "1407960099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 DIVISADERO ST",
            "address_2": "SUITE 625, BOX 1821",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941430001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 PARNASSUS AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432202",
            "telephone_number": "415-885-3799",
            "fax_number": "415-885-3864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUMMANENI",
        "first_name": "PRAVEEN",
        "middle_name": "V.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2008-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "A62374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A623740",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.