Individual provider Active NPI

Tracy Lynn Sirota, PNP

  • Pediatric Nurse Practitioner
  • San Francisco, CA
National Provider Identifier
1891056222
Registry record updated Jun 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
19154 Issued in CA
Practice address
505 Parnassus Ave Box 0210L767
San Francisco, CA 94143-0001
Phone
(415) 353-8284
NPI assigned
Jun 1, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 19154 CA Primary

Addresses

Primary practice location

505 Parnassus Ave Box 0210L767
San Francisco, CA 94143-0001

Mailing address

505 Parnassus Ave Box 0210L767
San Francisco, CA 94143-0001

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
I20120815000056 CA Practitioner - Nurse Practitioner 8022264613 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19154CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
UCSF Pediatrics Associates CurrentSince Jul 15, 2012 Accepting new patients
University of California San Francisco CurrentSince Jul 15, 2012 Accepting new patients
University of California San Francisco Current Accepting new patients
University of California San Francisco CurrentSince Jul 15, 2012 Accepting new patients

Locations

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

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

505 Parnassus Ave
#210L767
San Francisco, CA 94143
Phone (415) 353-8284

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.

NPI Registry JSON

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

{
    "created_epoch": "1338508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338508800000",
    "number": "1891056222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 PARNASSUS AVE BOX 0210L767",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941430001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 PARNASSUS AVE BOX 0210L767",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941430001",
            "telephone_number": "415-353-8284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIROTA",
        "first_name": "TRACY",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-01",
        "last_updated": "2012-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "19154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.