Individual provider Active NPI

Samuel NG

  • Student in an Organized Health Care Education/Training Program
  • San Francisco, CA
National Provider Identifier
1619439262
Registry record updated Apr 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
450 Stanyan St
San Francisco, CA 94117-1019
Phone
(415) 759-5942
Fax
(415) 750-5594
NPI assigned
Apr 3, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training ProgramGroup: 193400000X SINGLE SPECIALTY GROUP 390200000X CA Primary

Addresses

Primary practice location

450 Stanyan St
San Francisco, CA 94117-1019

Mailing address

450 Stanyan St
San Francisco, CA 94117-1019
Phone (415) 759-5942

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
I20240718002529 CA Practitioner - Rheumatology 0547607061 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
East Bay Rheumatology Medical Group, Inc.Group PAC ID 8022179977, 3 clinicians

Practice addresses (Care Compare)

13851 E 14TH St
Suite 102a
San Leandro, CA 94578-2631
Phone (510) 357-1303

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
East Bay Rheumatology Medical Group, Inc. Single Specialty CurrentSince Aug 1, 2024 Accepting new patients
California Pacific Medical Group, Inc. Past Accepting new patients

Locations

3737 Lone Tree Way
Ste E
Antioch, CA 94509
Phone (510) 357-1303

13851 E 14th St
Ste 102A
San Leandro, CA 94578
Phone (510) 333-1303

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: sng687290@hisp.ehr.sutterhealth.org

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1554249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554249600000",
    "number": "1619439262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 STANYAN ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941171019",
            "telephone_number": "415-759-5942",
            "fax_number": "415-750-5594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 STANYAN ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941171019",
            "telephone_number": "415-759-5942",
            "fax_number": "415-750-5594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NG",
        "first_name": "SAMUEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-03",
        "last_updated": "2019-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.