NPIMap

Individual provider Active NPI

Ingrid Roseborough, M.D.

  • Dermatology Physician
  • Oakland, CA
National Provider Identifier
1972636272
Registry record updated Sep 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
A92548 Issued in CA
Practice address
3300 Webster St
Ste 509
Oakland, CA 94609-3117
Phone
(510) 452-4900
Fax
(510) 452-2152
NPI assigned
Mar 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X A92548 CA Primary
Procedural Dermatology Physician 207NS0135X A92548 CA
Dermatology Physician 207N00000X 37075 IA

Addresses

Primary practice location

3300 Webster St
Ste 509
Oakland, CA 94609-3117

Mailing address

3300 Webster St
Ste 509
Oakland, CA 94609-3117
Phone (510) 452-4900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130213000169 CA Practitioner - Dermatology 9234275553 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Chicago, Pritzker School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ingrid Roseborough MD PCGroup PAC ID 7012161243, 2 clinicians

Practice addresses (Care Compare)

3300 Webster St
Suite 509
Oakland, CA 94609-3149
Phone (510) 452-0330

Merit-based Incentive Payment System (MIPS)

Final score
91.75 of 100Reported as individual
Quality
85
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision17
Removal of skin lesions1055
Removal or shaving of skin growth27
Skin biopsy296

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37075IAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of California San Francisco Current Accepting new patients
University of California San Francisco Dermatology CurrentSince Jan 1, 2013 Accepting new patients
UCSF Medical Group Business Services Dermatology CurrentSince Jan 1, 2013 Accepting new patients
Ingrid Roseborough, MD, PC Dermatology CurrentSince Jan 2, 2013 Accepting new patients
University of California San Francisco CurrentSince Jan 1, 2013 Accepting new patients
UCSF Medical Group Business Services CurrentSince Jan 1, 2013 Accepting new patients
California Pacific Medical Group, Inc. Past Accepting new patients
University of California San Francisco Past Accepting new patients
Dermatology Center of the East Bay, Inc. Dermatology PastSince Jul 14, 2020 Accepting new patients
University of California San Francisco Medical Center Past Accepting new patients
The Dermatology Group Dermatology Past Accepting new patients

Locations

3675 Mt Diablo Blvd
Ste 320
Lafayette, CA 94549
Phone (510) 452-0330

3511 School St
Lafayette, CA 94549
Phone (510) 452-0330

3300 Webster St
Ste 509
Oakland, CA 94609
Phone (510) 452-0330

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

1701 Divisadero St
San Francisco, CA 94115
Phone (415) 353-7300

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

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 11

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": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378857600000",
    "number": "1972636272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 WEBSTER ST",
            "address_2": "STE 509",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093117",
            "telephone_number": "510-452-4900",
            "fax_number": "510-452-2152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 WEBSTER ST",
            "address_2": "STE 509",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093117",
            "telephone_number": "510-452-4900",
            "fax_number": "510-452-2152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEBOROUGH",
        "first_name": "INGRID",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-14",
        "last_updated": "2013-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A92548",
            "primary": true
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "CA",
            "license": "A92548",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IA",
            "license": "37075",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.