Individual provider Active NPI

Michael Allen Fry, M.D.

  • Diagnostic Radiology Physician
  • San Francisco, CA
National Provider Identifier
1972545184
Registry record updated Mar 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
G86080 Issued in CA
Practice address
2333 Buchanan St FL 2
San Francisco, CA 94115-1925
Phone
(415) 600-6455
Fax
(415) 600-2870
NPI assigned
Jun 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X G86080 CA Primary

Addresses

Primary practice location

2333 Buchanan St FL 2
San Francisco, CA 94115-1925

Mailing address

PO Box 6102
Novato, CA 94948-6102
Phone (415) 884-3404

Other practice location 1

3555 Cesar Chavez
San Francisco, CA 94110-4403
Phone (415) 641-6545

Other practice location 2

1101 Van Ness Ave Fl 3
San Francisco, CA 94109-6919
Phone (415) 600-3232

Other identifiers 1

IdentifierTypeStateIssuer
00G860800MedicaidCA

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
I20080628000159 CA Practitioner - Diagnostic Radiology 0345312898 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Geisel School of Medicine at Dartmouth, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

1101 Van Ness Ave
San Francisco, CA 94109-6975
Phone (415) 600-3232

899 Valencia St
San Francisco, CA 94110-1736
Phone (415) 600-6960

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G86080CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation Current Accepting new patients
Sutter Bay Medical Foundation CurrentSince Aug 1, 2017 Accepting new patients
California Advanced Imaging Medical Associates Inc Diagnostic Radiology CurrentSince Nov 1, 2013 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Aug 1, 2017 Accepting new patients
California Pacific Advanced Imaging CurrentSince Jul 1, 2003 Accepting new patients
Sutter Bay Hospitals Past Accepting new patients
Sutter Bay Hospitals Past Accepting new patients
Sutter East Bay Medical Foundation Diagnostic Radiology Past Accepting new patients

Locations

901 Campus Dr
Ste 113
Daly City, CA 94015
Phone (650) 994-2595

1260 S Eliseo Dr
Ste 101
Greenbrae, CA 94904
Phone (415) 461-9033

5176 Hill Rd E
Lakeport, CA 95453
Phone (707) 262-5000

504 Redwood Blvd
Ste 300
Novato, CA 94947
Phone (415) 884-3418

795 El Camino Real
#1112
Palo Alto, CA 94301

2333 Buchanan St
Fl 2
San Francisco, CA 94115
Phone (415) 600-3600

2333 Buchanan St
San Francisco, CA 94115
Phone (415) 563-4321

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

55 2nd St
Fl Grnd
San Francisco, CA 94105
Phone (415) 600-6990

3838 California St
Rm 404
San Francisco, CA 94118
Phone (415) 600-0940

3555 Cesar Chavez
San Francisco, CA 94110
Phone (415) 485-8824

3700 California St
San Francisco, CA 94118
Phone (415) 719-0000

1101 Van Ness Ave
Fl 3
San Francisco, CA 94109
Phone (415) 600-1900

899 Valencia St
San Francisco, CA 94110
Phone (415) 600-6960

45 Castro St
San Francisco, CA 94114
Phone (415) 241-5695

3838 California St
Rm 410
San Francisco, CA 94118
Phone (415) 751-1847

1101 Van Ness Ave
San Francisco, CA 94109
Phone (415) 485-8824

100 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 696-4140

347 Andrieux St
Sonoma, CA 95476
Phone (707) 935-5000

Organizations & group practices 8

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": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1972545184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6102",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949486102",
            "telephone_number": "415-884-3404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2333 BUCHANAN ST FL 2",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941151925",
            "telephone_number": "415-600-6455",
            "fax_number": "415-600-2870"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3555 Cesar Chavez",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941104403",
            "country_code": "US",
            "telephone_number": "415-641-6545",
            "fax_number": "415-865-4175",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1101 Van Ness Ave Fl 3",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941096919",
            "country_code": "US",
            "telephone_number": "415-600-3232",
            "fax_number": "415-447-6335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRY",
        "first_name": "MICHAEL",
        "middle_name": "ALLEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G86080",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G860800",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.