Active NPI
Jonathan Isaac Roberts, NP
- Primary Care Nurse Practitioner
- San Francisco, CA
National Provider Identifier
1508641671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- License
- 12022
- Practice address
- 4150 Clement Street
San Francisco, CA 94121 - Phone
- (415) 221-4810
- NPI assigned
- Aug 28, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | 12022 | CT | Primary |
Addresses
Primary practice location
4150 Clement Street
San Francisco, CA 94121
Mailing address
4150 Clement Street
San Francisco, CA 94121
Phone (415) 221-4810
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12022 | CT | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1693180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693180800000",
"number": "1508641671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4150 CLEMENT STREET",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "94121",
"telephone_number": "415-221-4810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4150 CLEMENT STREET",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "94121",
"telephone_number": "415-221-4810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "JONATHAN",
"middle_name": "ISAAC",
"name_prefix": "Mr.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-08-28",
"last_updated": "2023-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "CT",
"license": "12022",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.