Organization Active NPI

Northbay Podiatric Medical GRP Inc

  • Podiatrist
  • San Francisco, CA
National Provider Identifier
1790887974
Registry record updated Dec 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E3203 Issued in CA
Legal business name
NORTHBAY PODIATRIC MEDICAL GRP INC
Practice address
728 Pacific Ave Ste 502
San Francisco, CA 94133-4449
Phone
(415) 981-8828
Fax
(415) 981-7002
NPI assigned
Sep 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2023

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

Authorized official

Name
Mr. Robert Y Choy, DPMNPI 1831148618
Title
Owner
Phone
(415) 981-8828

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X E3203 CA Primary
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X E4726 CA
Durable Medical Equipment & Medical Supplies 332B00000X E3203 CA

Addresses

Primary practice location

728 Pacific Ave Ste 502
San Francisco, CA 94133-4449

Mailing address

728 Pacific Ave Ste 502
San Francisco, CA 94133-4449
Phone (415) 981-8828

Other identifiers 2

IdentifierTypeStateIssuer
ZZZ05427ZOtherCABLUE SHIELD OF CA
ZZZ05428ZOtherCABLUE SHIELD OF CA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20071128000383 CA Part B Supplier - Clinic/Group Practice 1951490937 Receives reassigned benefits from 1 practitioner
Practice locations: San Francisco, CA
O20100930095494 CA DME Supplier - Physician - Podiatry 1951490937 Practice locations: San Francisco, CA

National Provider Directory

National Provider Directory

Locations

1620 Pennsylvania Ave
Ste A
Fairfield, CA 94533
Phone (707) 426-2575

728 Pacific Ave
Ste 502
San Francisco, CA 94133
Phone (415) 981-8828

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703548800000",
    "number": "1790887974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "728 PACIFIC AVE STE 502",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941334449",
            "telephone_number": "415-981-8828",
            "fax_number": "415-981-7002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "728 PACIFIC AVE STE 502",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941334449",
            "telephone_number": "415-981-8828",
            "fax_number": "415-981-7002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHBAY PODIATRIC MEDICAL GRP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-01",
        "last_updated": "2023-12-26",
        "certification_date": "2023-12-26",
        "status": "A",
        "authorized_official_last_name": "CHOY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "415-981-8828",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E3203",
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E4726",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "E3203",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA",
            "identifier": "ZZZ05427Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA",
            "identifier": "ZZZ05428Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.