Individual provider Active NPI

Mariam Khaled Ghanem, NP

  • Critical Care Pediatric Nurse Practitioner
  • San Francisco, CA
National Provider Identifier
1467257568
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Pediatric Nurse PractitionerTaxonomy code 363LP0222X
License
95033634 Issued in CA
Practice address
1975 4TH St
San Francisco, CA 94143-2351
Phone
(415) 476-1000
NPI assigned
Feb 13, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Pediatric Nurse Practitioner 363LP0222X 95033634 CA Primary

Addresses

Primary practice location

1975 4TH St
San Francisco, CA 94143-2351

Mailing address

7575 Kirby Dr Apt 3404
Houston, TX 77030-4453
Phone (936) 524-4255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of California San Francisco CurrentSince Mar 13, 2025 Accepting new patients
UCSF Medical Group Business Services CurrentSince Mar 13, 2025 Accepting new patients
University of California San Francisco Current Accepting new patients
UCSF Medical Group Business Services CurrentSince Mar 13, 2025 Accepting new patients
UCSF Pediatrics Associates CurrentSince Mar 13, 2025 Accepting new patients
University of California San Francisco CurrentSince Mar 13, 2025 Accepting new patients
University of California San Francisco Medical Center Past Accepting new patients

Locations

225 California Dr
Burlingame, CA 94010
Phone (415) 353-2002

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

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

1975 4th St
San Francisco, CA 94143
Phone (415) 353-3000

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

Interoperability endpoints

  • Direct secure messaging: mghanem408665@direct-ucsfmedicalcenter.org

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": "1739404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1467257568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7575 KIRBY DR APT 3404",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770304453",
            "telephone_number": "936-524-4255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1975 4TH ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432351",
            "telephone_number": "415-476-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHANEM",
        "first_name": "MARIAM",
        "middle_name": "KHALED",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-13",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0222X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics, Critical Care",
            "state": "CA",
            "license": "95033634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.