Juan C Caraballo, MD

Primary specialty

Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X

License

A137119 Issued in CA

Practice address

1900 Sullivan Ave
Daly City, CA 94015-2200

Phone

(319) 471-5877

NPI assigned

May 7, 2012

Last updated

Jun 19, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Juan Carlos Caraballo Fonseca Other name

Electronic endpoints 1

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

Specialty

Internal MedicineAlso: Critical Care (Intensivists)

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

San Francisco Critical Care Med Group IncGroup PAC ID 1850285602, 18 clinicians

Clarkian MedicalGroup PAC ID 5496161119, 3 clinicians

Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Inpatient Specialists of California PCGroup PAC ID 3476864448, 373 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ahmc Seton Medical Center Hospital, Daly City, CA, CCN 050289
• California Pacific Medical Center- Van Ness Campus Hospital, San Francisco, CA, CCN 050047
• UCSF Health St. Mary's Hospital Hospital, San Francisco, CA, CCN 050457

Merit-based Incentive Payment System (MIPS)

Final score

97.3 of 100Reported as group

Quality

82.96

Promoting interoperability

100

Improvement activities

40

Cost

74.7

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 44)

Interoperability endpoints

• Direct secure messaging: jcaraballo389236@hisp.ehr.sutterhealth.org

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.

• Clarkian Medical

  • Critical Care Medicine (Internal Medicine) Physician
  • Daly City, CA
  • NPI 1871103317
  Medicare reassignment Care Compare group NPD
• Inpatient Specialists of California, PC

  • Internal Medicine Physician
  • San Bernardino, CA
  • NPI 1952792475
  Medicare reassignment Care Compare group NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299
  Medicare reassignment Care Compare group NPD
• San Francisco Critical Care Med Group Inc

  • Pulmonary Disease Physician
  • San Francisco, CA
  • NPI 1215000211

  Critical Care Medicine

  Medicare reassignment Care Compare group NPD
• Sutter Bay Medical Foundation

  dba Palo Alto Medial Foundation

  • Multi-Specialty Clinic/Center
  • Palo Alto, CA
  • NPI 1013950807
  Medicare reassignment Care Compare group NPD
• Regents of the University of California

  dba UCSF Dept of Medicine General Medicine

  • Internal Medicine Physician
  • San Francisco, CA
  • NPI 1760552343
  Medicare reassignment NPD
• UCSF Medical Group Business Services

  • Internal Medicine Physician
  • San Francisco, CA
  • NPI 1477624104
  Medicare reassignment NPD
• University of California San Francisco

  dba UCSF Pediatrics Group

  • Pediatrics Physician
  • San Francisco, CA
  • NPI 1861578973
  Medicare reassignment NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Stockton, CA
  • NPI 1548343510
  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD
• Sutter Bay Medical Foundation

  dba Palo Alto Medical Foundation

  • Clinical Medical Laboratory
  • Santa Clara, CA
  • NPI 1669287033
  NPD
• UCSF Medical Group Business Services

  dba UCSF Orthotic and Prosthetic Center - Gateway Medical Building

  • Health Service Clinic/Center
  • San Francisco, CA
  • NPI 1194115246
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ahmc Seton Medical Center LLC

  dba Seton Medical Center ,Seton Medical Center Coastside

  • General Acute Care Hospital
  • Daly City, CA
  • NPI 1023636545
  Care Compare affiliation
• Ahmc Seton Medical Center LLC

  dba Seton Medical Center, Seton Medica Center Coastside

  • Psychiatric Hospital Unit
  • Daly City, CA
  • NPI 1639797855
  Care Compare affiliation
• Sutter Bay Hospitals

  • General Acute Care Hospital
  • San Francisco, CA
  • NPI 1740348929
  Care Compare affiliation
• UCSF Health Community Hospitals

  dba UCSF Health - St. Mary's Hospital

  • General Acute Care Hospital
  • San Francisco, CA
  • NPI 1174667158
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1336348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1508125907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SULLIVAN AVE",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940152200",
            "telephone_number": "319-471-5877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 SULLIVAN AVE",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940152200",
            "telephone_number": "319-471-5877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARABALLO",
        "first_name": "JUAN",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-07",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CA",
            "license": "A137119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2425 Geary Blvd",
            "city": "San Francisco",
            "state": "CA",
            "country_code": "US",
            "postal_code": "941153358",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JUAN",
            "last_name": "CARABALLO FONSECA",
            "middle_name": "CARLOS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jerwin Reyes Canta, LVN
• Felicia Cantu, LMFT
• Virgilio Capalla
• David John Capistrano, RN
• Michael A. Caplan, MD
• Bethany C Cardenas, SLP-A
• Kiara Cardenas
• Care Plust Medical Transport, LLC (Apollo Ambulance)
• Care4U Pharmacy Inc. (Care4U Pharmacy)
• Care4U Pharmacy Inc. (CARE4U Health Mart Pharmacy)

• Critical Care Medicine (Internal Medicine) Physician in Daly City, CA
• Providers in Daly City, CA by specialty
• Critical Care Medicine (Internal Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.