Individual provider Active NPI

Jessica Renee Poon, PT, DPT

  • Physical Therapist
  • San Francisco, CA
National Provider Identifier
1831964659
Registry record updated Nov 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
305146 Issued in CA
Practice address
3129 Vicente St
San Francisco, CA 94116-2740
Phone
(415) 661-1057
NPI assigned
Nov 21, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 305146 CA Primary

Addresses

Primary practice location

3129 Vicente St
San Francisco, CA 94116-2740

Mailing address

1216 Clay St Apt 202
San Francisco, CA 94108-1477
Phone (415) 627-7907

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240109000642 CA Practitioner - Physical Therapist in Private Practice 1052762689 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inner Bar IncGroup PAC ID 2163451634, 12 clinicians

Practice addresses (Care Compare)

550 15TH St
Suite 36a
San Francisco, CA 94103-5032
Phone (415) 682-9902

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
305146CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Inner Bar, Inc. Physical Therapist CurrentSince Mar 1, 2024 Accepting new patients

Locations

3401 Taraval St
San Francisco, CA 94116
Phone (415) 682-9902

550 15th St
Ste 36A
San Francisco, CA 94103
Phone (415) 682-9902

Organizations & group practices 1

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": "1700524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700524800000",
    "number": "1831964659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1216 CLAY ST APT 202",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941081477",
            "telephone_number": "415-627-7907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3129 VICENTE ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941162740",
            "telephone_number": "415-661-1057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POON",
        "first_name": "JESSICA",
        "middle_name": "RENEE",
        "name_prefix": "Ms.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-21",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "305146",
            "primary": true
        }
    ],
    "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 Nov 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.