Individual provider Active NPI

Jillian Graham Raghow, PA-C

  • Physician Assistant
  • San Francisco, CA
National Provider Identifier
1700368552
Registry record updated Mar 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
55890 Issued in CA
Practice address
535 Mission St Ste 100
San Francisco, CA 94105-3223
Phone
(415) 590-6275
Fax
(415) 291-0489
NPI assigned
Aug 29, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 55890 CA Primary

Addresses

Primary practice location

535 Mission St Ste 100
San Francisco, CA 94105-3223

Mailing address

1 Embarcadero Ctr Ste 1900
San Francisco, CA 94111-3723
Phone (415) 658-6791

Other identifiers 1

IdentifierTypeStateIssuer
PA55890OtherCAPA LICENSE

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
I20190108001163 CA Practitioner - Physician Assistant 1456697762 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
One Medical Group IncGroup PAC ID 2567623739, 330 clinicians

Practice addresses (Care Compare)

1004 Northgate Dr
San Rafael, CA 94903-2502
Phone (415) 590-6150

535 Mission St
San Francisco, CA 94105-2997
Phone (415) 590-6275

559 Clay St
Suite 200
San Francisco, CA 94111-3029
Phone (888) 663-6331

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
55890CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
One Medical Group, Inc. CurrentSince Mar 9, 2020 Accepting new patients
One Medical Group, Inc CurrentSince Mar 9, 2020 Accepting new patients
University of California San Francisco Past Accepting new patients

Locations

1955 Broadway
Ste A
Oakland, CA 94612

110 Sutter St
Fl 6
San Francisco, CA 94104
Phone (415) 392-8200

1 Embarcadero Ctr
Ste 1900
San Francisco, CA 94111

559 Clay St
#200
San Francisco, CA 94111
Phone (415) 830-4744

2950 S Delaware St
Ste 150
San Mateo, CA 94403

1004 Northgate Dr
San Rafael, CA 94903
Phone (415) 590-6150

1299 Oakmead Pkwy
Sunnyvale, CA 94085
Phone (408) 266-3100

Organizations & group practices 3

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": "1535500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583280000000",
    "number": "1700368552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR STE 1900",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113723",
            "telephone_number": "415-658-6791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 MISSION ST STE 100",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941053223",
            "telephone_number": "415-590-6275",
            "fax_number": "415-291-0489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAGHOW",
        "first_name": "JILLIAN",
        "middle_name": "GRAHAM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-29",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "55890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE",
            "identifier": "PA55890",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.