Individual provider Active NPI

Maryam Kermani, M.D

  • Family Medicine Physician
  • San Francisco, CA
National Provider Identifier
1548454283
Registry record updated Sep 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A100741 Issued in CA
Practice address
2 Embarcadero Ctr
Lobby Level
San Francisco, CA 94111-3823
Phone
(415) 578-3100
Fax
(415) 291-0489
NPI assigned
Sep 5, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A100741 CA Primary

Addresses

Primary practice location

2 Embarcadero Ctr
Lobby Level
San Francisco, CA 94111-3823

Mailing address

PO Box 779
San Francisco, CA 94104-7001
Phone (415) 658-6791

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
I20090310000066 CA Practitioner - Family Practice 6002972437 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A100741CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
One Medical Group, Inc Family Medicine CurrentSince Jun 12, 2012 Accepting new patients
One Medical Group, Inc. Family Medicine CurrentSince Jun 12, 2012 Accepting new patients

Locations

1955 Broadway
Ste A
Oakland, CA 94612

110 Sutter St
Fl 6
San Francisco, CA 94104
Phone (415) 392-8200

2 Embarcadero Ctr
Lbby
San Francisco, CA 94111
Phone (415) 529-4566

1 Embarcadero Ctr
Ste 1900
San Francisco, CA 94111

559 Clay St
#200
San Francisco, CA 94111
Phone (415) 830-4744

2950 S Delaware St
Ste 150
San Mateo, CA 94403

1004 Northgate Dr
San Rafael, CA 94903
Phone (415) 590-6150

1299 Oakmead Pkwy
Sunnyvale, CA 94085
Phone (408) 266-3100

Organizations & group practices 2

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": "1188950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378857600000",
    "number": "1548454283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 779",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941047001",
            "telephone_number": "415-658-6791",
            "fax_number": "415-520-0904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 EMBARCADERO CTR",
            "address_2": "LOBBY LEVEL",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113823",
            "telephone_number": "415-578-3100",
            "fax_number": "415-291-0489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERMANI",
        "first_name": "MARYAM",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-05",
        "last_updated": "2013-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A100741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.