NPIMap

University of California SFGH Medical Group

Organization Active NPI Surgery Physician · San Francisco, CA

NPI 1477528503 · NPPES record last updated Dec 18, 2025

Key facts

NPI
1477528503
Entity type
Organization (NPI type 2)
Primary specialty
Surgery Physician 208600000X
Legal business name
UNIVERSITY OF CALIFORNIA SFGH MEDICAL GROUP
Practice address
1001 Potrero Ave
RM 3A37
San Francisco, CA 94110-3518
Phone
(415) 206-4634
Fax
(415) 206-5484
NPI assigned
Feb 22, 2006
Organization subpart
No

Authorized official

Name
Juanita Villanueva
Title
Director
Phone
(415) 514-2574

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Other NPIs with the same Medicare PAC ID 13

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 42

Organizations that report the same tax identification number in the National Provider Directory.

View all 42

Practitioners 625

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

View all 625

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20050328001092 CA Part B Supplier - Clinic/Group Practice 5496668410 Receives reassigned benefits from 85 practitioners
2 other NPIs on this enrollment
Practice locations: San Francisco, CA

National Provider Directory

Tax ID family
SFGH Medical Group (43 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208200000X
Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208600000X Yes

Addresses

Primary practice location

1001 Potrero Ave
RM 3A37
San Francisco, CA 94110-3518

Mailing address

PO Box 743749
Los Angeles, CA 90074-3749
Phone (415) 514-3000

Other identifiers

IdentifierTypeStateIssuer
ZZZP3861ZMedicaidCA

Other names

  • UCSF SFGH Medical Group Dept of General Surgery Doing business as

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Bluemark LLC / Office Ally

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 18, 2025.

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766016000000",
    "number": "1477528503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743749",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900743749",
            "telephone_number": "415-514-3000",
            "fax_number": "415-502-8175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 POTRERO AVE",
            "address_2": "RM 3A37",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941103518",
            "telephone_number": "415-206-4634",
            "fax_number": "415-206-5484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF CALIFORNIA SFGH MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-22",
        "last_updated": "2025-12-18",
        "certification_date": "2025-12-18",
        "status": "A",
        "authorized_official_last_name": "VILLANUEVA",
        "authorized_official_first_name": "JUANITA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "415-514-2574"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZP3861Z",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.3",
            "affiliationName": "Bluemark LLC / Office Ally",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "1300 SE Cardinal Ct Ste 190",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986839683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "UCSF SFGH Medical Group Dept of General Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Francisco, CA

All providers in San Francisco, CA · Surgery Physician in California

Sources for this page

Verify at the official NPI Registry.