Individual provider Active NPI

Marisa Gardner, MD

  • Neurology with Special Qualifications in Child Neurology Physician
  • San Francisco, CA
National Provider Identifier
1477882587
Registry record updated Aug 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
A110006 Issued in CA
Practice address
505 Parnassus Ave
San Francisco, CA 94143-2204
Phone
(415) 476-6245
NPI assigned
Dec 18, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A110006 CA
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X A110006 CA Primary

Addresses

Primary practice location

505 Parnassus Ave
San Francisco, CA 94143-2204

Mailing address

868 Minnesota St Unit 212
San Francisco, CA 94107-3584

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190212000611 CA Practitioner - NeurologyPractitioner - Pediatric Medicine 1456699727 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A110006CAMDNeurology with Special Qualifications in Child Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of California San Francisco CurrentSince Nov 26, 2018 Accepting new patients
UCSF Medical Group Business Services CurrentSince Nov 26, 2018 Accepting new patients
UCSF Medical Group Business Services CurrentSince Nov 26, 2018 Accepting new patients
University of California San Francisco Pediatrics Current Accepting new patients
University of California San Francisco Pediatrics CurrentSince Nov 26, 2018 Accepting new patients
UCSF Pediatrics Associates Pediatrics CurrentSince Nov 26, 2018 Accepting new patients
University of California San Francisco Medical Center Past Accepting new patients

Locations

747 52nd St
Oakland, CA 94609
Phone (510) 428-3070

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

3333 California St
#S110
San Francisco, CA 94118
Phone (415) 514-2664

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

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

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

400 Parnassus Ave
#300
San Francisco, CA 94143
Phone (415) 476-2163

2303 Camino Ramon
Ste 175
San Ramon, CA 94583
Phone (925) 979-3470

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: mgardner13505@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": "1261094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691107200000",
    "number": "1477882587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "868 MINNESOTA ST UNIT 212",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941073584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 PARNASSUS AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432204",
            "telephone_number": "415-476-6245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "MARISA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-18",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A110006",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "CA",
            "license": "A110006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.