Individual provider Active NPI

Yuvadee Tai

  • Family Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1558868349
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95008383 Issued in CA
Practice address
5500 Campanile Dr San Diego Ca
San Diego, CA 92182-3373
Phone
(619) 594-4325
NPI assigned
Apr 9, 2018
Last updated
Nov 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95008383 CA Primary

Addresses

Primary practice location

5500 Campanile Dr San Diego Ca
San Diego, CA 92182-3373

Mailing address

2636 Telegraph Ave
Berkeley, CA 94704-3373

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
I20191203002910 CA Practitioner - Nurse Practitioner 6901239003 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95008383CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
City and County of San Francisco CurrentSince Sep 21, 2020 Accepting new patients
City & County of San Francisco CurrentSince Sep 21, 2020 Accepting new patients
City & County of San Francisco Current Accepting new patients
Thomas K. Stern, M.D. P.C. PastSince Dec 13, 2020 Accepting new patients

Locations

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

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": "1523232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1558868349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2636 TELEGRAPH AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947043373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 CAMPANILE DR SAN DIEGO CA",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921823373",
            "telephone_number": "619-594-4325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAI",
        "first_name": "YUVADEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-09",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95008383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.