NPIMap

Individual provider Active NPI

Nelson Branco, MD

  • Pediatrics Physician
  • Larkspur, CA
National Provider Identifier
1841270451
Registry record updated Jun 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A60826 Issued in CA
Practice address
5 Bon Air Road
Ste. 105
Larkspur, CA 94939
Phone
(415) 461-0440
Fax
(415) 461-3792
NPI assigned
Jan 19, 2006
Last updated
Jun 3, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A60826 CA Primary

Addresses

Primary practice location

5 Bon Air Road
Ste. 105
Larkspur, CA 94939

Mailing address

5 Bon Air Road
Ste. 105
Larkspur, CA 94939
Phone (415) 461-0440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200708000301 TX Practitioner - Pediatric Medicine 4688097744 Reassigns benefits to 1 organization
I20220223002988 CA Practitioner - Pediatric Medicine 4688097744 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Regents Univ of California UCSF Pediatrics CurrentSince Nov 18, 2021 Accepting new patients
Tuba City Regional Health Care Corporation CurrentSince Jun 22, 2020 Accepting new patients
Tuba City Regional Health Care Corporation Pediatrics Current Accepting new patients
Tuba City Regional Health Care Corporation CurrentSince Jun 22, 2020 Accepting new patients
Tamalpais Pediatrics Pediatrics Past Accepting new patients

Locations

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

Interoperability endpoints

  • Direct secure messaging: nbranco@tampeds.pcc-direct.com
  • Direct secure messaging: nbranco58838@direct-ucsfmedicalcenter.org

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Marin Community ClinicNovato, CA, CCN 051945 Federally qualified health center Corporate Director Jan 1, 2021
Marin Community ClinicNovato, CA, CCN 751885 Federally qualified health center Corporate Director (5%) Jan 1, 2021
Marin Community ClinicSan Rafael, CA, CCN A01145 Federally qualified health center Corporate Director (5%) Jul 1, 2022
Marin Community ClinicSan Rafael, CA, CCN A01974 Federally qualified health center Corporate Director Oct 1, 2020

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433289600000",
    "number": "1841270451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 BON AIR ROAD",
            "address_2": "STE. 105",
            "city": "LARKSPUR",
            "state": "CA",
            "postal_code": "94939",
            "telephone_number": "415-461-0440",
            "fax_number": "415-461-3792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 BON AIR ROAD",
            "address_2": "STE. 105",
            "city": "LARKSPUR",
            "state": "CA",
            "postal_code": "94939",
            "telephone_number": "415-461-0440",
            "fax_number": "415-461-3792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANCO",
        "first_name": "NELSON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2015-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A60826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Larkspur, CA

Sources for this page

Verify at the official NPI Registry.