Individual provider Active NPI

Jen Lemelin, N.P.

  • Acute Care Nurse Practitioner
  • San Francisco, CA
National Provider Identifier
1558669374
Registry record updated Mar 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
20431 Issued in CA
Practice address
1001 Potrero Ave
San Francisco, CA 94110-3518
Phone
(415) 206-8111
NPI assigned
Mar 2, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 20431 CA Primary

Addresses

Primary practice location

1001 Potrero Ave
San Francisco, CA 94110-3518

Mailing address

3205 Canyon Creek LN
Santa Rosa, CA 95404-8406
Phone (707) 539-5787

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
I20110519000236 CA Practitioner - Nurse Practitioner 2860678224 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
20431CAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
City and County of San Francisco CurrentSince Jun 16, 2024 Accepting new patients
City & County of San Francisco Acute Care CurrentSince Jun 16, 2024 Accepting new patients
City & County of San Francisco Current Accepting new patients

Locations

375 Laguna Honda Blvd
#B200
San Francisco, CA 94116
Phone (415) 759-3348

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

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": "1299024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299024000000",
    "number": "1558669374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3205 CANYON CREEK LN",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954048406",
            "telephone_number": "707-539-5787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 POTRERO AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941103518",
            "telephone_number": "415-206-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEMELIN",
        "first_name": "JEN",
        "credential": "N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-02",
        "last_updated": "2011-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "20431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.