Individual provider Active NPI

Jessica Danielle Pitluk, M.D.

  • Family Medicine Physician
  • San Rafael, CA
National Provider Identifier
1790970366
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A115360 Issued in CA
Practice address
1004 Northgate Dr
San Rafael, CA 94903-2502
Phone
(415) 590-6150
Fax
(415) 252-7176
NPI assigned
Sep 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A115360 CA Primary

Addresses

Primary practice location

1004 Northgate Dr
San Rafael, CA 94903-2502

Mailing address

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

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
I20200917002364 CA Practitioner - Family Practice 7214052117 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Arizona College of Medicine, 2007
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

Hospital & facility affiliations

  • Marinhealth Medical Center Hospital, Greenbrae, CA, CCN 050360
  • Novato Community Hospital Hospital, Novato, CA, CCN 050131

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A115360CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
One Medical Group, Inc Family Medicine CurrentSince Nov 9, 2020 Accepting new patients
One Medical Group, Inc. Family Medicine CurrentSince Nov 9, 2020 Accepting new patients
Caresimple Providers PS Family Medicine Past Accepting new patients
Carena Medical Providers PS Family Medicine Past Accepting new patients

Locations

350 Bon Air Ctr
Ste 200
Greenbrae, CA 94904
Phone (415) 578-3095

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 4

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.

Hospital & facility affiliations 2

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": "1189123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1790970366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1004 NORTHGATE DR",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949032502",
            "telephone_number": "415-590-6150",
            "fax_number": "415-578-3118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 NORTHGATE DR",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949032502",
            "telephone_number": "415-590-6150",
            "fax_number": "415-252-7176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITLUK",
        "first_name": "JESSICA",
        "middle_name": "DANIELLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-07",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A115360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

Verify at the official NPI Registry.