Individual provider Active NPI

Jacob Sonnenberg

  • Surgery Physician
  • San Francisco, CA
National Provider Identifier
1770335754
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
15516 Issued in CA
Practice address
513 Parnassus Avenue
S-321
San Francisco, CA 94143-2205
Phone
(415) 476-1239
NPI assigned
Apr 3, 2024
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 15516 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

513 Parnassus Avenue
S-321
San Francisco, CA 94143-2205

Mailing address

513 Parnassus Avenue
S-321
San Francisco, CA 94143-2205

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
I20250408002933 CA Order and Referring Only - General SurgeryPractitioner - General Surgery 5698299907

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15516CAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1712102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1770335754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 PARNASSUS AVENUE",
            "address_2": "S-321",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 PARNASSUS AVENUE",
            "address_2": "S-321",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432205",
            "telephone_number": "415-476-1239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONNENBERG",
        "first_name": "JACOB",
        "sole_proprietor": "NO",
        "sex": "U",
        "enumeration_date": "2024-04-03",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "15516",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.