Individual provider Active NPI

Kristina Coale Stillwell, M.D.

  • Student in an Organized Health Care Education/Training Program
  • San Diego, CA
National Provider Identifier
1659661718
Registry record updated Apr 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
402 Dickinson St
MPF1-140
San Diego, CA 92103-6902
Phone
(858) 249-1702
NPI assigned
Apr 11, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2017

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 Program 390200000X Primary

Addresses

Primary practice location

402 Dickinson St
MPF1-140
San Diego, CA 92103-6902

Mailing address

402 Dickinson St
MPF1-140
San Diego, CA 92103-6902

Other names 1

  • Kristina C Coale Former name

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
I20170811002739 CA Practitioner - Pediatric Medicine 9436420270 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of California San Francisco CurrentSince Jul 1, 2017 Accepting new patients
University of California San Francisco Current Accepting new patients
University of California San Francisco CurrentSince Jul 1, 2017 Accepting new patients
UCSF Medical Group Business Services CurrentSince Jul 1, 2017 Accepting new patients
UCSF Medical Group Business Services CurrentSince Jul 1, 2017 Accepting new patients
UCSF Pediatrics Associates CurrentSince Jul 1, 2017 Accepting new patients
University of California San Francisco Medical Center Past Accepting new patients
University of California San Francisco Past Accepting new patients

Locations

400 Parnassus Ave
#300
San Francisco, CA 94143
Phone (415) 476-2163

550 16th St
Fl 5
San Francisco, CA 94143
Phone (415) 476-5153

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

1825 4th St
San Francisco, CA 94143
Phone (415) 353-3000

400 Parnassus Ave
San Francisco, CA 94143
Phone (415) 353-2000

3333 California St
#S110
San Francisco, CA 94118
Phone (415) 514-2664

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

Interoperability endpoints

  • Direct secure messaging: kstillwell86732@direct-ucsfmedicalcenter.org

Organizations & group practices 8

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": "1302480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491436800000",
    "number": "1659661718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 DICKINSON ST",
            "address_2": "MPF1-140",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921036902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 DICKINSON ST",
            "address_2": "MPF1-140",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921036902",
            "telephone_number": "858-249-1702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STILLWELL",
        "first_name": "KRISTINA",
        "middle_name": "COALE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-11",
        "last_updated": "2017-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTINA",
            "last_name": "COALE",
            "middle_name": "C",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.