Active NPI
Jerrold Steven Wittert, M.D.
- Specialist
- San Francisco, CA
National Provider Identifier
1568793107
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- G26317
- Practice address
- 4462 17TH St
San Francisco, CA 94114-1807 - Phone
- (510) 537-5533
- Fax
- (415) 861-6530
- NPI assigned
- Jan 21, 2010
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Specialist | 174400000X | G26317 | CA | Primary |
Addresses
Primary practice location
4462 17TH St
San Francisco, CA 94114-1807
Mailing address
4462 17TH St
San Francisco, CA 94114-1807
Phone (628) 287-4001
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 1, 2025 through Apr 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26317 | CA | MD | Endodontist |
| G26317 | CA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1264032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782691200000",
"number": "1568793107",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4462 17TH ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941141807",
"telephone_number": "628-287-4001",
"fax_number": "415-861-6530"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4462 17TH ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941141807",
"telephone_number": "510-537-5533",
"fax_number": "415-861-6530"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WITTERT",
"first_name": "JERROLD",
"middle_name": "STEVEN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-01-21",
"last_updated": "2026-06-29",
"certification_date": "2026-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CA",
"license": "G26317",
"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 Jun 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.