Individual provider Active NPI

Susan Ehrlich, MD

  • Internal Medicine Physician
  • San Mateo, CA
National Provider Identifier
1942379474
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A79518 Issued in CA
Practice address
222 W 39TH Ave
San Mateo, CA 94403-4364
Phone
(650) 573-2222
NPI assigned
Nov 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A79518 CA Primary

Addresses

Primary practice location

222 W 39TH Ave
San Mateo, CA 94403-4364

Mailing address

249 Jersey St
San Francisco, CA 94114-3822
Phone (650) 573-2222

Other identifiers 1

IdentifierTypeStateIssuer
00A795180MedicaidCA

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
I20110906000075 CA Practitioner - Internal Medicine 7214093715 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
79518CAMDPharmacist
A79518CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
City & County of San Francisco CurrentSince Nov 10, 2019 Accepting new patients
City & County of San Francisco Current Accepting new patients
University of California SFGH Medical Group Current Accepting new patients
City and County of San Francisco CurrentSince Nov 10, 2019 Accepting new patients
County of San Mateo PastSince Mar 3, 2008 Accepting new patients

Locations

1001 Potrero Ave
San Francisco, CA 94110
Phone (415) 206-2305

1001 Potrero Ave
Rm 5H22
San Francisco, CA 94110
Phone (628) 206-4774

Organizations & group practices 5

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": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942379474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "249 JERSEY ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941143822",
            "telephone_number": "650-573-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 W 39TH AVE",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944034364",
            "telephone_number": "650-573-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EHRLICH",
        "first_name": "SUSAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A79518",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A795180",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

Verify at the official NPI Registry.