Individual provider Active NPI

Shelley Miller Mitchell, CRNA

  • Certified Registered Nurse Anesthetist
  • San Francisco, CA
National Provider Identifier
1922209170
Registry record updated Sep 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
CRNA3201 Issued in CA
Practice address
1001 Potrero Ave # 3C38
SFGH Anesthesia
San Francisco, CA 94110-3518
Phone
(415) 206-8213
Fax
(415) 206-6014
NPI assigned
May 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Registered Nurse 163WM0705X RN512627 CA
Certified Registered Nurse Anesthetist 367500000X CRNA3201 CA Primary

Addresses

Primary practice location

1001 Potrero Ave # 3C38
SFGH Anesthesia
San Francisco, CA 94110-3518

Mailing address

1001 Potrero Ave # 3C38
SFGH Anesthesia
San Francisco, CA 94110-3518
Phone (415) 206-8213

Other identifiers 1

IdentifierTypeStateIssuer
107359OtherSFGH INTERNAL USE ONLY-COMMERCIAL NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201207000383 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 4284045774 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of California SFGH Medical GroupGroup PAC ID 5496668410, 566 clinicians

Practice addresses (Care Compare)

1001 Potrero Ave
San Francisco, CA 94110-3518

1001 Potrero Ave BLDG 80 Ward 83
Suite 32
San Francisco, CA 94110-3518
Phone (628) 206-8610

Hospital & facility affiliations

  • Zuckerberg San Francisco General Hosp & Trauma Ctr Hospital, San Francisco, CA, CCN 050228

Merit-based Incentive Payment System (MIPS)

Final score
97.28 of 100Reported as group
Quality
89.92
Promoting interoperability
100
Improvement activities
40
Cost
78.23

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN512627CAMDMedical-Surgical Registered Nurse
CRNA3201CAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
University of California SFGH Medical Group CurrentSince Oct 25, 2020 Accepting new patients
University of California SFGH Medical Group CurrentSince Oct 25, 2020 Accepting new patients

Locations

1001 Potrero Ave
Rm 3C34
San Francisco, CA 94110
Phone (628) 206-8934

1001 Potrero Ave
Bldg 5
San Francisco, CA 94110
Phone (628) 206-5753

1001 Potrero Ave
#3C38
San Francisco, CA 94110
Phone (628) 206-8145

Organizations & group practices 2

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 2

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": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317340800000",
    "number": "1922209170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 POTRERO AVE # 3C38",
            "address_2": "SFGH ANESTHESIA",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941103518",
            "telephone_number": "415-206-8213",
            "fax_number": "415-206-6014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 POTRERO AVE # 3C38",
            "address_2": "SFGH ANESTHESIA",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941103518",
            "telephone_number": "415-206-8213",
            "fax_number": "415-206-6014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "SHELLEY",
        "middle_name": "MILLER",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-29",
        "last_updated": "2011-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "CA",
            "license": "RN512627",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "CRNA3201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SFGH INTERNAL USE ONLY-COMMERCIAL NUMBER",
            "identifier": "107359",
            "state": null
        }
    ],
    "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 Sep 30, 2011; 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.