Individual provider Active NPI

Andrea Harzstark, MD

  • Hematology & Oncology Physician
  • San Francisco, CA
National Provider Identifier
1871766576
Registry record updated Dec 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
A86175 Issued in CA
Practice address
1600 Divisadero St
Urologic Oncology, 3Rd Floor, Box 1711
San Francisco, CA 94143-3010
Phone
(415) 353-7171
NPI assigned
Apr 2, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X A86175 CA Primary

Addresses

Primary practice location

1600 Divisadero St
Urologic Oncology, 3Rd Floor, Box 1711
San Francisco, CA 94143-3010

Mailing address

1600 Divisadero St
Urologic Oncology, 3Rd Floor, Box 1711
San Francisco, CA 94143-3010

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, HI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20080806000788 CA Practitioner - Hematology/OncologyPractitioner - Internal Medicine 9234203357 Reassigns benefits to 1 organization
I20260603002780 HI Practitioner - Hematology/Oncology 9234203357 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Stanford University School of Medicine, 2002
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

711 Kapiolani Blvd
Honolulu, HI 96813-5237

711 Kapiolani Blvd
Suite 220
Honolulu, HI 96813-5276

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A86175CAMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group, Inc CurrentSince Apr 11, 2015 Accepting new patients
Permanente Medical Group Inc CurrentSince Apr 11, 2015 Accepting new patients

Locations

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

2425 Geary Blvd
San Francisco, CA 94115
Phone (415) 833-2200

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

Organizations & group practices 3

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": "1207094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1871766576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 DIVISADERO ST",
            "address_2": "UROLOGIC ONCOLOGY, 3RD FLOOR, BOX 1711",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941433010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 DIVISADERO ST",
            "address_2": "UROLOGIC ONCOLOGY, 3RD FLOOR, BOX 1711",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941433010",
            "telephone_number": "415-353-7171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARZSTARK",
        "first_name": "ANDREA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-02",
        "last_updated": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "A86175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2425 Geary Blvd",
            "city": "San Francisco",
            "state": "CA",
            "country_code": "US",
            "postal_code": "941153358",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.