Organization Active NPI

Pacific Gynecology Surgical Group Inc

  • Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
  • San Francisco, CA
National Provider Identifier
1861865479
Registry record updated Dec 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianTaxonomy code 207VF0040X
Legal business name
PACIFIC GYNECOLOGY SURGICAL GROUP INC
Practice address
2100 Webster St Ste 518
San Francisco, CA 94115-2382
Phone
(415) 426-7859
Fax
(415) 426-7805
NPI assigned
Nov 4, 2015
Last updated
Dec 1, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2015

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

Authorized official

Name
Leslie KardosNPI 1831187046
Title
Owner
Phone
(415) 426-7859

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician 207VF0040X NU Primary

Addresses

Primary practice location

2100 Webster St Ste 518
San Francisco, CA 94115-2382

Mailing address

2100 Webster St Ste 518
San Francisco, CA 94115-2382
Phone (415) 426-7859

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160118000541 CA Part B Supplier - Clinic/Group Practice 0244533701 Receives reassigned benefits from 1 practitioner
Practice locations: San Francisco, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2108301Pacific Gynecology Surgical Group2100 Webster St Ste 518, San Francisco, CA 94115Provider-performed microscopyFeb 1, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1446595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448928000000",
    "number": "1861865479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 WEBSTER ST STE 518",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941152382",
            "telephone_number": "415-426-7859",
            "fax_number": "415-426-7805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 WEBSTER ST STE 518",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941152382",
            "telephone_number": "415-426-7859",
            "fax_number": "415-426-7805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC GYNECOLOGY SURGICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-04",
        "last_updated": "2015-12-01",
        "status": "A",
        "authorized_official_last_name": "KARDOS",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "415-426-7859"
    },
    "taxonomies": [
        {
            "code": "207VF0040X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "NU",
            "license": null,
            "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 Dec 1, 2015; 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.