Individual provider Active NPI

Adir Magidish, FNP

  • Family Nurse Practitioner
  • Sausalito, CA
National Provider Identifier
1851896336
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP95033722 Issued in CA
Practice address
100 Phillips Dr
Sausalito, CA 94965-1172
Phone
(415) 339-8813
Fax
(415) 339-8814
NPI assigned
Mar 27, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X
Family Nurse Practitioner 363LF0000X NP95033722 CA Primary
Behavior Technician 106S00000X

Addresses

Primary practice location

100 Phillips Dr
Sausalito, CA 94965-1172

Mailing address

100 Phillips Dr
Sausalito, CA 94965-1172
Phone (415) 339-8813

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250710003121 CA Practitioner - Nurse Practitioner 9931613890 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Phillips Dr
Sausalito, CA 94965-1172
Phone (415) 339-8813

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP95033722CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Marin City Health and Wellness Center Current Accepting new patients
Marin City Health and Wellness Center CurrentSince Apr 8, 2025 Accepting new patients
Marin City Health and Wellness Center CurrentSince Apr 8, 2025 Accepting new patients
Ed Support Services Behavior Analyst Past Accepting new patients

Locations

880 Las Gallinas Ave
Ste 2
San Rafael, CA 94903
Phone (415) 339-8813

100 Phillips Dr
Sausalito, CA 94965
Phone (415) 339-8813

630 Drake Ave
Sausalito, CA 94965
Phone (415) 339-8813

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 1

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": "1522108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1851896336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PHILLIPS DR",
            "city": "SAUSALITO",
            "state": "CA",
            "postal_code": "949651172",
            "telephone_number": "415-339-8813",
            "fax_number": "415-339-8814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PHILLIPS DR",
            "city": "SAUSALITO",
            "state": "CA",
            "postal_code": "949651172",
            "telephone_number": "415-339-8813",
            "fax_number": "415-339-8814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGIDISH",
        "first_name": "ADIR",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-27",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95033722",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sausalito, CA

Sources for this page

Verify at the official NPI Registry.