Active NPI
Rezvaneh Ghasemzadeh, MD
- Pediatrics Physician
- San Francisco, CA
National Provider Identifier
1548751852
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- A163802
- Practice address
- 550 16TH St FL 5
San Francisco, CA 94158-2545 - Phone
- (415) 502-2338
- Fax
- (415) 476-2602
- NPI assigned
- May 22, 2018
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | A163802 | CA | Primary |
Addresses
Primary practice location
550 16TH St FL 5
San Francisco, CA 94158-2545
Mailing address
550 16TH St FL 5
San Francisco, CA 94158-2545
Phone (415) 502-2338
Other practice location 1
9300 Valley Childrens Pl
Madera, CA 93636-8761
Phone (515) 593-5174
Other practice location 2
2920 Telegraph Ave Ste 200
Berkeley, CA 94705-2031
Phone (510) 486-8344
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231109000198 | CA | Order and Referring Only - Pediatric Medicine | 6901208560 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A163802 | CA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1526947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629676800000",
"number": "1548751852",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "550 16TH ST FL 5",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941582545",
"telephone_number": "415-502-2338",
"fax_number": "415-476-2602"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "550 16TH ST FL 5",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941582545",
"telephone_number": "415-502-2338",
"fax_number": "415-476-2602"
}
],
"practiceLocations": [
{
"address_1": "9300 Valley Childrens Pl",
"address_purpose": "LOCATION",
"city": "Madera",
"state": "CA",
"postal_code": "936368761",
"country_code": "US",
"telephone_number": "515-593-5174",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2920 Telegraph Ave Ste 200",
"address_purpose": "LOCATION",
"city": "Berkeley",
"state": "CA",
"postal_code": "947052031",
"country_code": "US",
"telephone_number": "510-486-8344",
"fax_number": "510-885-3746",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GHASEMZADEH",
"first_name": "REZVANEH",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-22",
"last_updated": "2021-08-23",
"certification_date": "2021-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "A163802",
"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 23, 2021; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.