Individual provider Active NPI

Sophany Roeung, NP

  • Nurse Practitioner
  • San Francisco, CA
National Provider Identifier
1699263434
Registry record updated Sep 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95008476 Issued in CA
Practice address
1825 4TH St
San Francisco, CA 94143-2350
Phone
(440) 781-8729
NPI assigned
Apr 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95008476 CA
Nurse Practitioner 363L00000X 95008476 CA Primary

Addresses

Primary practice location

1825 4TH St
San Francisco, CA 94143-2350

Mailing address

182 Midcrest Way
San Francisco, CA 94131-1240
Phone (440) 781-8729

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181018001643 CA Practitioner - Nurse Practitioner 7517210602 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95008476CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of California San Francisco CurrentSince Sep 20, 2018 Accepting new patients
UCSF Medical Group Business Services CurrentSince Sep 20, 2018 Accepting new patients
UCSF Pediatrics Associates CurrentSince Sep 20, 2018 Accepting new patients
University of California San Francisco Current Accepting new patients
Regents of the University of California CurrentSince Sep 20, 2018 Accepting new patients
UCSF Medical Group Business Services Nurse Practitioner CurrentSince Sep 20, 2018 Accepting new patients
University of California San Francisco CurrentSince Sep 20, 2018 Accepting new patients
UCSF Dept of Surgery CurrentSince Sep 20, 2018 Accepting new patients

Locations

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

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

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

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

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

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

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

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": "1524700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536883200000",
    "number": "1699263434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "182 MIDCREST WAY",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941311240",
            "telephone_number": "440-781-8729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 4TH ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432350",
            "telephone_number": "440-781-8729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROEUNG",
        "first_name": "SOPHANY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-26",
        "last_updated": "2018-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95008476",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95008476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.