Theresia Soetjipto, MS,NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

21074 Issued in CA

Practice address

505 Parnassus Ave # M-361
Campus Box 0628
San Francisco, CA 94143-2204

Phone

(415) 353-1300

Fax

(415) 353-8570

NPI assigned

Jan 4, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

UCSF Medical Group Business ServicesGroup PAC ID 3779497870, 1,533 clinicians

University of California San FranciscoGroup PAC ID 4486567229, 1,780 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• UCSF Medical Center Hospital, San Francisco, CA, CCN 050454
• Adventist Health Ukiah Valley Hospital, Ukiah, CA, CCN 050301
• Adventist Health Clearlake Hospital, Clearlake, CA, CCN 051317

Merit-based Incentive Payment System (MIPS)

Final score

84.89 of 100Reported as group

Quality

81.13

Improvement activities

40

Cost

71.5

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tsoetjipto27302@direct-ucsfmedicalcenter.org

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.

• UCSF Medical Group Business Services

  • Internal Medicine Physician
  • San Francisco, CA
  • NPI 1477624104

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• University of California San Francisco

  • Pediatrics Physician
  • San Francisco, CA
  • NPI 1861578973
  Medicare reassignment Care Compare group NPD
• Regents of the University of California

  • Internal Medicine Physician
  • San Francisco, CA
  • NPI 1760552343
  Medicare reassignment NPD
• UCSF Pediatrics Associates

  • Pediatrics Physician
  • San Francisco, CA
  • NPI 1376614016
  Medicare reassignment NPD
• UCSF Medical Group Business Services

  • Health Service Clinic/Center
  • San Francisco, CA
  • NPI 1194115246
  NPD
• University of California San Francisco

  • Internal Medicine Physician
  • San Francisco, CA
  • NPI 1164512851
  NPD
• University of California San Francisco

  • Community/Retail Pharmacy
  • San Francisco, CA
  • NPI 1659141711
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Adventist Health Clearlake Hospital Inc.

  • Critical Access Hospital
  • Clearlake, CA
  • NPI 1124018031
  Care Compare affiliation
• Ukiah Adventist Hospital

  • General Acute Care Hospital
  • Ukiah, CA
  • NPI 1235120676
  Care Compare affiliation
• University of California, San Francisco

  • General Acute Care Hospital
  • San Francisco, CA
  • NPI 1689772592
  Care Compare affiliation

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

{
    "created_epoch": "1451865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451865600000",
    "number": "1932565181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 PARNASSUS AVE # M-361",
            "address_2": "CAMPUS BOX 0628",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 PARNASSUS AVE # M-361",
            "address_2": "CAMPUS BOX 0628",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432204",
            "telephone_number": "415-353-1300",
            "fax_number": "415-353-8570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOETJIPTO",
        "first_name": "THERESIA",
        "name_prefix": "Ms.",
        "credential": "MS,NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-04",
        "last_updated": "2016-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "21074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Otuwakemi Ayomide Sodire
• James Than Soe, PHARMD
• Kyaw K Soe
• Myat H Soe, M.D.
• Pyone Wai Wai Soe, M.D.
• Ike Sofaer, MFT
• Theresa Ann Sofarelli, P.A.-C
• David Jack Soffa, MD
• Adam Soffrin
• Luka Sogorovic

• Nurse Practitioner in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.