Individual provider Active NPI

James Matthew Wantuck, M.D.

  • Internal Medicine Physician
  • San Francisco, CA
National Provider Identifier
1821301110
Registry record updated Jan 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A117984 Issued in CA
Practice address
2261 Market St # 86887
San Francisco, CA 94114-1612
Phone
(855) 516-7755
Fax
(650) 672-3681
NPI assigned
Jul 15, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A117984 CA Primary
Family Medicine Physician 207Q00000X A117984 CA

Addresses

Primary practice location

2261 Market St # 86887
San Francisco, CA 94114-1612

Mailing address

2261 Market St # 86887
San Francisco, CA 94114-1612
Phone (855) 516-7755

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prsca Medical Group PC Family Medicine Current Accepting new patients
Prsnj Medical Group PC Family Medicine Current Accepting new patients
Prsmt Medical Group PC Family Medicine Current Accepting new patients
Executive Medicine, Inc. Internal Medicine Past Accepting new patients

Locations

1212 Broadway Plz
Ste 2100
Walnut Creek, CA 94596
Phone (650) 485-3459

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.

NPI Registry JSON

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

{
    "created_epoch": "1279152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767744000000",
    "number": "1821301110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2261 MARKET ST # 86887",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941141612",
            "telephone_number": "855-516-7755",
            "fax_number": "650-672-3681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2261 MARKET ST # 86887",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941141612",
            "telephone_number": "855-516-7755",
            "fax_number": "650-672-3681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANTUCK",
        "first_name": "JAMES",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-15",
        "last_updated": "2026-01-07",
        "certification_date": "2026-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A117984",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A117984",
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Jan 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.