Individual provider Active NPI

Jennifer M. Puck, M.D.

  • Pediatric Allergy/Immunology Physician
  • San Francisco, CA
National Provider Identifier
1871525378
Registry record updated Jun 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Allergy/Immunology PhysicianTaxonomy code 2080P0201X
License
G87720 Issued in CA
Practice address
1825 Fouth Street, 6TH Floor
Immunology Center
San Francisco, CA 94158
Phone
(415) 502-2090
Fax
(415) 502-2107
NPI assigned
Jul 7, 2006
Last updated
Jun 5, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X G87720 CA
Pediatric Allergy/Immunology Physician 2080P0201X G87720 CA Primary

Addresses

Primary practice location

1825 Fouth Street, 6TH Floor
Immunology Center
San Francisco, CA 94158

Mailing address

550 16TH St
Box 0434
San Francisco, CA 94143
Phone (415) 502-2090

Other identifiers 1

IdentifierTypeStateIssuer
00G877200MedicaidCA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060809000425 CA Practitioner - Pediatric Medicine 2365445434 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
87720CAMDPharmacist
G87720CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of California San Francisco Pediatrics CurrentSince Jul 1, 2007 Accepting new patients
UCSF Medical Group Business Services CurrentSince Apr 10, 2011 Accepting new patients
UCSF Pediatrics Associates Pediatrics CurrentSince Jul 1, 2007 Accepting new patients
UCSF Medical Group Business Services CurrentSince Apr 10, 2011 Accepting new patients
University of California San Francisco CurrentSince Jul 1, 2007 Accepting new patients
University of California San Francisco Pediatrics Current Accepting new patients
University of California San Francisco Medical Center Past Accepting new patients

Locations

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

3333 California St
#S110
San Francisco, CA 94118
Phone (415) 514-2664

400 Parnassus Ave
San Francisco, CA 94143
Phone (415) 353-2000

400 Parnassus Ave
#300
San Francisco, CA 94143
Phone (415) 476-3131

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

400 Parnassus Ave
Fl 2
San Francisco, CA 94143
Phone (415) 353-2008

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

550 16th St
San Francisco, CA 94143
Phone (415) 353-1238

550 16th St
San Francisco, CA 94158
Phone (415) 476-2188

550 16th St
#434
San Francisco, CA 94143
Phone (510) 428-3331

550 16th St
#434
San Francisco, CA 94158
Phone (415) 476-3831

Organizations & group practices 7

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433462400000",
    "number": "1871525378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 16TH ST",
            "address_2": "BOX 0434",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94143",
            "telephone_number": "415-502-2090",
            "fax_number": "415-502-2107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 FOUTH STREET, 6TH FLOOR",
            "address_2": "IMMUNOLOGY CENTER",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94158",
            "telephone_number": "415-502-2090",
            "fax_number": "415-502-2107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUCK",
        "first_name": "JENNIFER",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2015-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G87720",
            "primary": false
        },
        {
            "code": "2080P0201X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Allergy/Immunology",
            "state": "CA",
            "license": "G87720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G877200",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.