Individual provider Active NPI

Miranda E. Surjadi, NP MS

  • Acute Care Nurse Practitioner
  • San Francisco, CA
National Provider Identifier
1548384365
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
NPF11790 Issued in CA
Practice address
1001 Potrero Ave # 3D7
SFGH Gastroenterology
San Francisco, CA 94110-3518
Phone
(415) 206-4776
Fax
(415) 206-5199
NPI assigned
Mar 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Registered Nurse 163WG0100X RN546712 CA
Acute Care Nurse Practitioner 363LA2100X NPF11790 CA Primary

Addresses

Primary practice location

1001 Potrero Ave # 3D7
SFGH Gastroenterology
San Francisco, CA 94110-3518

Mailing address

1001 Potrero Ave # 3D7
SFGH Gastroenterology
San Francisco, CA 94110-3518
Phone (415) 206-4776

Other identifiers 1

IdentifierTypeStateIssuer
117390OtherSFGH INTERNAL USE ONLY-COMMERCIAL NUMBER

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050519001104 CA Practitioner - Nurse Practitioner 4981645892 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN546712CAMDGastroenterology Registered Nurse
NPF11790CAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
City & County of San Francisco Current Accepting new patients
City and County of San Francisco CurrentSince Jan 28, 2017 Accepting new patients
City & County of San Francisco Acute Care CurrentSince Jan 28, 2017 Accepting new patients

Locations

1001 Potrero Ave
#3D7
San Francisco, CA 94110
Phone (415) 206-4776

1001 Potrero Ave
San Francisco, CA 94110
Phone (415) 206-2305

1001 Potrero Ave
Bldg 20
San Francisco, CA 94110
Phone (415) 206-8524

Organizations & group practices 3

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": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1548384365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 POTRERO AVE # 3D7",
            "address_2": "SFGH GASTROENTEROLOGY",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941103518",
            "telephone_number": "415-206-4776",
            "fax_number": "415-206-5199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 POTRERO AVE # 3D7",
            "address_2": "SFGH GASTROENTEROLOGY",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941103518",
            "telephone_number": "415-206-4776",
            "fax_number": "415-206-5199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURJADI",
        "first_name": "MIRANDA",
        "middle_name": "E.",
        "name_prefix": "Ms.",
        "credential": "NP MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gastroenterology",
            "state": "CA",
            "license": "RN546712",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "NPF11790",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SFGH INTERNAL USE ONLY-COMMERCIAL NUMBER",
            "identifier": "117390",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.