Individual provider Active NPI

David Drevno, PNP

  • Pediatric Nurse Practitioner
  • Oakland, CA
National Provider Identifier
1780941161
Registry record updated Jun 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
21033 Issued in CA
Practice address
747 52ND St
Oakland, CA 94609-1809
Phone
(510) 428-3058
NPI assigned
Apr 23, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 21033 CA Primary

Addresses

Primary practice location

747 52ND St
Oakland, CA 94609-1809

Mailing address

747 52ND St
Gastroenterology
Oakland, CA 94609-1809
Phone (510) 428-3058

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
I20190906003272 CA Practitioner - Nurse Practitioner 6709115322 Reassigns benefits to 4 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of California San Francisco CurrentSince Jul 15, 2019 Accepting new patients
University of California San Francisco Current Accepting new patients
UCSF Dept of Surgery CurrentSince Jul 15, 2019 Accepting new patients
UCSF Medical Group Business Services CurrentSince Jul 15, 2019 Accepting new patients
UCSF Pediatrics Associates CurrentSince Jul 15, 2019 Accepting new patients
UCSF Medical Group Business Services CurrentSince Jul 15, 2019 Accepting new patients
University of California San Francisco CurrentSince Jul 15, 2019 Accepting new patients
University of California San Francisco Medical Center Past Accepting new patients
University of California San Francisco Past Accepting new patients

Locations

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

747 52nd St
Fl 5
Oakland, CA 94609
Phone (510) 428-3233

400 Parnassus Ave
#300
San Francisco, CA 94143
Phone (415) 476-3131

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

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

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

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

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

Interoperability endpoints

  • Direct secure messaging: ddrevno26082@direct-ucsfmedicalcenter.org

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1335139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402617600000",
    "number": "1780941161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "747 52ND ST",
            "address_2": "GASTROENTEROLOGY",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946091809",
            "telephone_number": "510-428-3058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 52ND ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946091809",
            "telephone_number": "510-428-3058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DREVNO",
        "first_name": "DAVID",
        "credential": "PNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-23",
        "last_updated": "2014-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "21033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.