Individual provider Active NPI

Priyanka Ghosh, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • San Mateo, CA
National Provider Identifier
1558756791
Registry record updated May 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
169421A Issued in CA
Practice address
1900 Ofarrell St Ste 190
San Mateo, CA 94403-1372
Phone
(650) 306-9490
NPI assigned
Apr 4, 2015
Last updated
May 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X 169421A CA Primary

Addresses

Primary practice location

1900 Ofarrell St Ste 190
San Mateo, CA 94403-1372

Mailing address

1900 Ofarrell St Ste 190
San Mateo, CA 94403-1372
Phone (650) 306-9490

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
I20201007000379 CA Practitioner - Anesthesiology 4183952658 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of California, San Francisco School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Remedy Medical GroupGroup PAC ID 7618166091, 12 clinicians

Practice addresses (Care Compare)

1900 Ofarrell St
Suite 190
San Mateo, CA 94403-1372
Phone (650) 306-9490

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
169421ACAMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
James Petros, M.D., Inc. Multi-Specialty CurrentSince Oct 1, 2020 Accepting new patients
James Petros, M.D., Inc. Multi-Specialty CurrentSince Oct 1, 2020 Accepting new patients
Remedy Medical Group Multi-Specialty CurrentSince Apr 7, 2021 Accepting new patients
California Pacific Medical Group, Inc. Past Accepting new patients

Locations

14777 Los Gatos Blvd
Ste 202
Los Gatos, CA 95032
Phone (408) 784-7515

3300 Webster St
Ste 601
Oakland, CA 94609
Phone (510) 272-9610

1330 Tara Hills Dr
Ste E105
Pinole, CA 94564
Phone (650) 667-2322

490 Post St
Ste 900
San Francisco, CA 94102
Phone (415) 362-7177

490 Post St
Ste 901
San Francisco, CA 94102
Phone (415) 421-2256

1604 Blossom Hill Rd
Ste 10
San Jose, CA 95124
Phone 4085288833605

175 N Jackson Ave
Ste 109
San Jose, CA 95116
Phone (408) 445-8400

1900 Ofarrell St
Ste 190
San Mateo, CA 94403
Phone 6503069490 ext. 119

880 Las Gallinas Ave
Ste 6
San Rafael, CA 94903
Phone (415) 499-3399

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1428105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683244800000",
    "number": "1558756791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 OFARRELL ST STE 190",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944031372",
            "telephone_number": "650-306-9490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 OFARRELL ST STE 190",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944031372",
            "telephone_number": "650-306-9490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHOSH",
        "first_name": "PRIYANKA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-04",
        "last_updated": "2023-05-05",
        "certification_date": "2023-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "169421A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

Verify at the official NPI Registry.