Individual provider Active NPI

Daniel P. Pellegrini, MD

  • Specialist
  • Sausalito, CA
National Provider Identifier
1649245176
Registry record updated Jun 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G88091 Issued in CA
Practice address
302 4TH St
Sausalito, CA 94965-2409
Phone
(510) 220-9384
NPI assigned
Feb 20, 2006
Last updated
Jun 16, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD062510L PA
Specialist 174400000X G88091 CA Primary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 84758 CT
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X W1873 TX

Addresses

Primary practice location

302 4TH St
Sausalito, CA 94965-2409

Mailing address

200 W Magnolia Ave Ste 201
Fort Worth, TX 76104-7657
Phone (817) 702-2977

Other practice location 1

263 Farmington Ave
Farmington, CT 06030-8063
Phone (860) 679-8080

Other practice location 2

1500 S Main St
Fort Worth, TX 76104-4917
Phone (817) 702-1100

Other identifiers 1

IdentifierTypeStateIssuer
001659480MedicaidPA

Electronic endpoints 2

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group
Direct Messaging Address dpellegrini100580@direct.med.uchc.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20080225000663 CA Practitioner - Thoracic SurgeryPractitioner - Cardiac Surgery 2668556911 Reassigns benefits to 2 organizations
I20260121004260 TX Practitioner - Cardiac Surgery 2668556911 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiac Surgery
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1441 N Beckley Ave
Dallas, TX 75203-1201

200 W Magnolia Ave
Fort Worth, TX 76104-7657

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G88091CAMDSpecialist
MD062510LPAMDSpecialist
W1873TXMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health Physicians Network Current Accepting new patients
Permanente Medical Group Inc Current Accepting new patients
Adventist Health Physicians Network CurrentSince Apr 23, 2025 Accepting new patients
Adventist Health Physicians Network Thoracic Surgery (Cardiothoracic Vascular Surgery) CurrentSince Apr 23, 2025 Accepting new patients
Permanente Medical Group, Inc CurrentSince Nov 27, 2010 Accepting new patients
Permanente Medical Group Inc CurrentSince Nov 27, 2010 Accepting new patients
Medhealth CurrentSince Jan 11, 2026 Accepting new patients
Acclaim Physician Group, Inc CurrentSince Feb 18, 2026 Accepting new patients
Medhealth CurrentSince Jan 11, 2026 Accepting new patients
University of California San Francisco Medical Center Past Accepting new patients
UCSF Medical Group Business Services Past Accepting new patients
UCSF Dept of Surgery Thoracic Surgery (Cardiothoracic Vascular Surgery) Past Accepting new patients
Three Rivers Cardiac Institute Inc. Thoracic Surgery (Cardiothoracic Vascular Surgery) Past Accepting new patients

Locations

275 W MacArthur Blvd
Piedmont, CA 94611
Phone (510) 752-1375

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

2238 Geary Blvd
Fl 8
San Francisco, CA 94115
Phone (415) 823-8856

2425 Geary Blvd
San Francisco, CA 94115
Phone (415) 833-2200

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

1007 Live Oak Blvd
Ste B2
Yuba City, CA 95991
Phone (530) 671-8718

1350 S Main St
Fl 1
Fort Worth, TX 76104
Phone (817) 702-3701

1500 S Main St
Ft Worth, TX 76104
Phone (817) 921-3431

200 W Magnolia Ave
Ste 201
Ft Worth, TX 76104
Phone (817) 702-2450

5224 S State Highway 360
Grand Prairie, TX 75052
Phone (972) 522-0691

2800 E Broad St
Ste 514
Mansfield, TX 76063
Phone (682) 253-2986

Organizations & group practices 13

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.

View all 13

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": "1140393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781568000000",
    "number": "1649245176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W MAGNOLIA AVE STE 201",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761047657",
            "telephone_number": "817-702-2977",
            "fax_number": "817-702-2140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 4TH ST",
            "city": "SAUSALITO",
            "state": "CA",
            "postal_code": "949652409",
            "telephone_number": "510-220-9384"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "263 Farmington Ave",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "CT",
            "postal_code": "060308063",
            "country_code": "US",
            "telephone_number": "860-679-8080",
            "fax_number": "860-679-1430",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1500 S Main St",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761044917",
            "country_code": "US",
            "telephone_number": "817-702-1100",
            "fax_number": "817-702-2140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PELLEGRINI",
        "first_name": "DANIEL",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-20",
        "last_updated": "2026-06-16",
        "certification_date": "2026-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PA",
            "license": "MD062510L",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G88091",
            "primary": true
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "CT",
            "license": "84758",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "TX",
            "license": "W1873",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001659480",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2425 Geary Blvd",
            "city": "San Francisco",
            "state": "CA",
            "country_code": "US",
            "postal_code": "941153358",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dpellegrini100580@direct.med.uchc.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "263 Farmington Ave",
            "city": "Farmington",
            "state": "CT",
            "country_code": "US",
            "postal_code": "060308063",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sausalito, CA

Sources for this page

Verify at the official NPI Registry.