Individual provider Active NPI

Carolina Ellinger Da Fonseca, MD

  • Pediatrics Physician
  • San Francisco, CA
National Provider Identifier
1689253403
Registry record updated Aug 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A196003 Issued in CA
Practice address
1975 4TH St
San Francisco, CA 94143-2351
Phone
(415) 514-4079
NPI assigned
Apr 7, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X A196003 CA Primary
Pediatrics Physician 208000000X 4351047788 MI

Addresses

Primary practice location

1975 4TH St
San Francisco, CA 94143-2351

Mailing address

22201 Moross Rd Ste 80
Detroit, MI 48236-2169
Phone (313) 343-3800

Other practice location 1

22201 Moross Rd Ste 80
Detroit, MI 48236-2169
Phone (313) 343-3800

Other names 1

  • Carolina Fonseca Other 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
I20250730001873 CA Practitioner - Pediatric Medicine 2961932025 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A196003CAMDPediatrics Physician
4351047788MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of California San Francisco CurrentSince Jul 16, 2025 Accepting new patients
University of California San Francisco Pediatrics Current Accepting new patients
UCSF Pediatrics Associates Pediatrics CurrentSince Jul 16, 2025 Accepting new patients
Regents Univ of California UCSF Pediatrics CurrentSince Jul 28, 2025 Accepting new patients
UCSF Medical Group Business Services CurrentSince Jul 16, 2025 Accepting new patients
UCSF Medical Group Business Services CurrentSince Jul 16, 2025 Accepting new patients
University of California San Francisco Pediatrics CurrentSince Jul 16, 2025 Accepting new patients

Locations

747 52nd St
Oakland, CA 94609
Phone (510) 428-3070

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

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

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

1975 4th St
San Francisco, CA 94143
Phone (415) 353-3000

Interoperability endpoints

  • Direct secure messaging: cellingerdafonseca368733@direct-ucsfmedicalcenter.org
  • Direct secure messaging: cfonseca808414@direct.hfhs.org
  • Direct secure messaging: cellingerdafonseca151979@direct.whhs.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1617753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1689253403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22201 MOROSS RD STE 80",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482362169",
            "telephone_number": "313-343-3800",
            "fax_number": "313-343-4756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1975 4TH ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432351",
            "telephone_number": "415-514-4079"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22201 Moross Rd Ste 80",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482362169",
            "country_code": "US",
            "telephone_number": "313-343-3800",
            "fax_number": "313-343-4756",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLINGER DA FONSECA",
        "first_name": "CAROLINA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-07",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A196003",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4351047788",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLINA",
            "last_name": "FONSECA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.