Individual provider Active NPI

Elizabeth Theresa Jasolosky, DO

  • Family Medicine Physician
  • San Francisco, CA
National Provider Identifier
1598051807
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MB09629500 Issued in NJ
Practice address
1 California St Ste 2300
San Francisco, CA 94111-5424
Phone
(800) 997-6196
Fax
(415) 504-1367
NPI assigned
Jun 24, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DO00767 RI
Family Medicine Physician 207Q00000X 83803 SC
Family Medicine Physician 207Q00000X H84356 MD
Family Medicine Physician 207Q00000X 281255-1 NY
Family Medicine Physician 207Q00000X OS018981 PA
Family Medicine Physician 207Q00000X 5101023703 MI
Family Medicine Physician 207Q00000X 70859 MN
Family Medicine Physician 207Q00000X 2022006317 MO
Family Medicine Physician 207Q00000X 273844 MA
Family Medicine Physician 207Q00000X T6602 TX
Family Medicine Physician 207Q00000X 0102203861 VA
Family Medicine Physician 207Q00000X 02005242A IN
Family Medicine Physician 207Q00000X 34.013114 OH
Family Medicine Physician 207Q00000X 2022-00187 NC
Family Medicine Physician 207Q00000X 25MB09629500 NJ Primary

Addresses

Primary practice location

1 California St Ste 2300
San Francisco, CA 94111-5424

Mailing address

1 California St Ste 2300
San Francisco, CA 94111-5424
Phone (800) 997-6196

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20151007001030 NJ Practitioner - Family Practice 4981821493 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Rowan University School of Osteopathic Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Doctor on Demand Professionals of New Jersey PCGroup PAC ID 3476835851, 6 clinicians

Practice addresses (Care Compare)

100 Charles Ewing Blvd
Princeton South Corporate Ctr Suite 160
Ewing, NJ 08628-3454
Phone (800) 997-6196

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
02005242AINMDFamily Medicine Physician
273844MAMDFamily Medicine Physician
H84356MDMDFamily Medicine Physician
5101023703MIMDFamily Medicine Physician
70859MNMDFamily Medicine Physician
2022006317MOMDFamily Medicine Physician
2022-00187NCMDFamily Medicine Physician
25MB09629500NJMDFamily Medicine Physician
281255-1NYMDFamily Medicine Physician
34.013114OHMDFamily Medicine Physician
OS018981PAMDFamily Medicine Physician
83803SCMDFamily Medicine Physician
T6602TXMDFamily Medicine Physician
0102203861VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Doctor on Demand Professionals of New Jersey, P.C. Family Medicine CurrentSince Mar 1, 2020 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Ozarks Medical Center Family Medicine Past Accepting new patients

Locations

1 California St
Ste 2300
San Francisco, CA 94111
Phone (800) 929-0926

100 Charles Ewing Blvd
Ste 160
Trenton, NJ 08628
Phone (212) 878-7685

Interoperability endpoints

  • Direct secure messaging: elizabeth.jasolosky.1@30520.direct.athenahealth.com

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": "1308873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1598051807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CALIFORNIA ST STE 2300",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941115424",
            "telephone_number": "800-997-6196",
            "fax_number": "415-504-1367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CALIFORNIA ST STE 2300",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941115424",
            "telephone_number": "800-997-6196",
            "fax_number": "415-504-1367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JASOLOSKY",
        "first_name": "ELIZABETH",
        "middle_name": "THERESA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-24",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "RI",
            "license": "DO00767",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "83803",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "H84356",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "281255-1",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS018981",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101023703",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "70859",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2022006317",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "273844",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "T6602",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102203861",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02005242A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34.013114",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2022-00187",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB09629500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.