Individual provider Active NPI

Elvera Sofos, M.D.

  • Pediatrics Physician
  • San Mateo, CA
National Provider Identifier
1578806808
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A132341 Issued in CA
Practice address
50 S San Mateo Dr Ste 180
San Mateo, CA 94401-3859
Phone
(650) 342-4145
NPI assigned
Apr 4, 2013
Last updated
Jul 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A132341 CA Primary

Addresses

Primary practice location

50 S San Mateo Dr Ste 180
San Mateo, CA 94401-3859

Mailing address

50 S San Mateo Dr Ste 180
San Mateo, CA 94401-3859
Phone (650) 342-4145

Other practice location 1

750 S Bascom Ave
San Jose, CA 95128-2603
Phone (408) 885-5410

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
I20161221002117 CA Practitioner - Pediatric Medicine 9931480498 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
132341CAMDMarriage & Family Therapist
A132341CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Santa Clara CurrentSince Nov 15, 2016 Accepting new patients
LPCH Medical Group Div of Lucile Pediatrics CurrentSince May 13, 2024 Accepting new patients
County of Santa Clara Current Accepting new patients
County of Santa Clara CurrentSince Nov 15, 2016 Accepting new patients
Peninsula Pediatric Med GRP Inc Pediatrics Past Accepting new patients
Foster City Pediatric Medical Group Inc Pediatrics Past Accepting new patients
Peninsula Pediatric Med GRP Inc Pediatrics PastSince Jul 21, 2024 Accepting new patients

Locations

725 Welch Rd
Palo Alto, CA 94304
Phone (650) 497-8979

750 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-2320

Interoperability endpoints

  • Direct secure messaging: esofos66252@santaclaravalley.direct-ci.net

Organizations & group practices 7

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": "1365033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1578806808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 S SAN MATEO DR STE 180",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944013859",
            "telephone_number": "650-342-4145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 S SAN MATEO DR STE 180",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944013859",
            "telephone_number": "650-342-4145"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "750 S Bascom Ave",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951282603",
            "country_code": "US",
            "telephone_number": "408-885-5410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOFOS",
        "first_name": "ELVERA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-04",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A132341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

Verify at the official NPI Registry.