Individual provider Active NPI

Carlo Andrei De la Sancha Verduzco

  • Cytopathology Physician
  • San Francisco, CA
National Provider Identifier
1972038222
Registry record updated Apr 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cytopathology PhysicianTaxonomy code 207ZC0500X
License
A171656 Issued in CA
Practice address
1001 Potrero Ave RM 114
San Francisco, CA 94110-3518
Phone
(628) 206-6068
NPI assigned
Apr 25, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology (Pathology) Physician 207ZD0900X A171656 CA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X A171656 CA
Student in an Organized Health Care Education/Training Program 390200000X 11019158A IN
Cytopathology Physician 207ZC0500X A171656 CA Primary

Addresses

Primary practice location

1001 Potrero Ave RM 114
San Francisco, CA 94110-3518

Mailing address

350 W 11TH St
Suite 4083
Indianapolis, IN 46202-4108
Phone (317) 274-2476

Other practice location 1

350 W 11th St
Suite 4083
Indianapolis, IN 46202-4108
Phone (317) 274-2476

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
I20230803003012 CA Practitioner - Pathology 5496028672 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2014
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
Phone (628) 206-8212

Hospital & facility affiliations

  • Zuckerberg San Francisco General Hosp & Trauma Ctr Hospital, San Francisco, CA, CCN 050228
  • Laguna Honda Hospital & Rehabilitation Center Hospital, San Francisco, CA, CCN 050668

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A171656CAMDDermatopathology (Pathology) Physician
11019158AINMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
City and County of San Francisco CurrentSince Aug 21, 2023 Accepting new patients
City & County of San Francisco CurrentSince Aug 21, 2023 Accepting new patients
University of California SFGH Medical Group CurrentSince Jul 18, 2023 Accepting new patients
University of California SFGH Medical Group CurrentSince Jul 18, 2023 Accepting new patients
University of California SFGH Medical Group Current Accepting new patients
City & County of San Francisco Current Accepting new patients

Locations

1001 Potrero Ave
Rm 114
San Francisco, CA 94110
Phone (628) 206-6068

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

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

1001 Potrero Ave
Bldg 3
San Francisco, CA 94110
Phone (415) 206-6068

Organizations & group practices 6

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 3

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": "1493078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680393600000",
    "number": "1972038222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 W 11TH ST",
            "address_2": "SUITE 4083",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462024108",
            "telephone_number": "317-274-2476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 POTRERO AVE RM 114",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941103518",
            "telephone_number": "628-206-6068"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 W 11th St",
            "address_2": "Suite 4083",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462024108",
            "country_code": "US",
            "telephone_number": "317-274-2476",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE LA SANCHA VERDUZCO",
        "first_name": "CARLO",
        "middle_name": "ANDREI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-25",
        "last_updated": "2023-04-02",
        "certification_date": "2023-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "CA",
            "license": "A171656",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "A171656",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": "11019158A",
            "primary": false
        },
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "CA",
            "license": "A171656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.