NPIMap

Individual provider Active NPI

Randy Jackson Jr., MD

  • Family Medicine Physician
  • San Francisco, CA
National Provider Identifier
1437681301
Registry record updated Mar 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A169485 Issued in CA
Practice address
995 Potrero Ave
San Francisco, CA 94110-2859
Phone
(628) 206-5252
NPI assigned
Mar 30, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A169485 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

995 Potrero Ave
San Francisco, CA 94110-2859

Mailing address

995 Potrero Ave
San Francisco, CA 94110-2859
Phone (628) 206-5252

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
I20200824002883 CA Practitioner - Family Practice 3779858428 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1001 Potrero Ave
San Francisco, CA 94110-3518

1001 Potrero Ave BLDG 80 Ward 83
Suite 32
San Francisco, CA 94110-3518
Phone (628) 206-8610

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.28 of 100Reported as group
Quality
89.92
Promoting interoperability
100
Improvement activities
40
Cost
78.23

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A169485CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
UCSF Medical Group Business Services CurrentSince Aug 27, 2020 Accepting new patients
City & County of San Francisco Current Accepting new patients
UCSF Medical Group Business Services CurrentSince Aug 27, 2020 Accepting new patients
University of California SFGH Medical Group CurrentSince Dec 12, 2020 Accepting new patients
University of California San Francisco Current Accepting new patients
University of California SFGH Medical Group Family Medicine CurrentSince Dec 12, 2020 Accepting new patients
University of California SFGH Medical Group Current Accepting new patients
University of California San Francisco CurrentSince Aug 27, 2020 Accepting new patients
University of California San Francisco CurrentSince Aug 27, 2020 Accepting new patients
City and County of San Francisco CurrentSince Dec 22, 2020 Accepting new patients

Locations

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

1001 Potrero Ave
Bldg 80
San Francisco, CA 94110
Phone (628) 206-8610

1001 Potrero Ave
San Francisco, CA 94110
Phone (415) 206-2305

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

1100 Park Pl
Ste 100
San Mateo, CA 94403
Phone (415) 353-3236

Organizations & group practices 10

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 2

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": "1490832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1437681301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "995 POTRERO AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941102859",
            "telephone_number": "628-206-5252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "995 POTRERO AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941102859",
            "telephone_number": "628-206-5252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "RANDY",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-30",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A169485",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.