Individual provider Active NPI

Hayley Rae Vandenberg, PA

  • Surgical Physician Assistant
  • San Francisco, CA
National Provider Identifier
1730602376
Registry record updated Aug 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA57700 Issued in CA
Practice address
1600 Divisadero St
San Francisco, CA 94143-3010
Phone
(415) 353-4201
NPI assigned
Jul 25, 2017
Last updated
Aug 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA18331 TX
Surgical Physician Assistant 363AS0400X PA57700 CA Primary

Addresses

Primary practice location

1600 Divisadero St
San Francisco, CA 94143-3010

Mailing address

1600 Divisadero St
San Francisco, CA 94143-3010

Other practice location 1

608 Radam Ln
Austin, TX 78745-1172
Phone (512) 443-5988

Other names 1

  • Hayley Rae Johnson 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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200619001470 CA Practitioner - Physician Assistant 2668746884 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Florida College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
UCSF Dept of SurgeryGroup PAC ID 7719886373, 211 clinicians

Practice addresses (Care Compare)

505 Parnassus Ave
San Francisco, CA 94143-2204
Phone (415) 476-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.23 of 100Reported as group
Quality
77.83
Promoting interoperability
98
Improvement activities
40
Cost
71.17

Merit-based Incentive Payment System (MIPS)

Final score
89.14 of 100Reported as group
Quality
84.79
Promoting interoperability
99
Improvement activities
40
Cost
73.15

Merit-based Incentive Payment System (MIPS)

Final score
93.2 of 100Reported as group
Promoting interoperability
92
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA18331TXMDPhysician Assistant
PA57700CAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cedars-Sinai Medical Care Foundation CurrentSince Aug 1, 2020 Accepting new patients
University of California San Francisco CurrentSince Aug 11, 2025 Accepting new patients
UCSF Medical Group Business Services CurrentSince Aug 11, 2025 Accepting new patients
Cedars-Sinai Medical Center CurrentSince Jul 1, 2020 Accepting new patients
UCSF Medical Group Business Services CurrentSince Aug 11, 2025 Accepting new patients
Cedars-Sinai Medical Center CurrentSince Jul 1, 2020 Accepting new patients
University of California San Francisco CurrentSince Aug 11, 2025 Accepting new patients

Locations

3100 San Pablo Ave
Berkeley, CA 94702
Phone (510) 985-5020

8635 W 3rd St
Ste 465W
Los Angeles, CA 90048
Phone (310) 423-0674

1600 Divisadero St
San Francisco, CA 94143
Phone (415) 567-6600

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

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

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

4140 W 190th St
Torrance, CA 90504
Phone (310) 967-1780

8700 Beverly Blvd
West Hollywood, CA 90048
Phone (310) 385-3291

Interoperability endpoints

  • Direct secure messaging: hayleyjohnson@uroaustin.medalliesdirect.net
  • Direct secure messaging: hvandenberg434443@direct-ucsfmedicalcenter.org

Organizations & group practices 12

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.

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": "1500940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756080000000",
    "number": "1730602376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 DIVISADERO ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941433010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 DIVISADERO ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941433010",
            "telephone_number": "415-353-4201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "608 Radam Ln",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787451172",
            "country_code": "US",
            "telephone_number": "512-443-5988",
            "fax_number": "512-443-5055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANDENBERG",
        "first_name": "HAYLEY",
        "middle_name": "RAE",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-25",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA18331",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA57700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HAYLEY",
            "last_name": "JOHNSON",
            "middle_name": "RAE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.