Individual provider Active NPI

Peggy Ross, NP

  • Nurse Practitioner
  • San Rafael, CA
National Provider Identifier
1982742185
Registry record updated Aug 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2784 Issued in CA
Practice address
1004 Northgate Dr
San Rafael, CA 94903-2502
Phone
(888) 663-6331
NPI assigned
Feb 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2784 CA Primary

Addresses

Primary practice location

1004 Northgate Dr
San Rafael, CA 94903-2502

Mailing address

1 Embarcadero Ctr Ste 1900
San Francisco, CA 94111-3723
Phone (888) 663-6331

Other practice location 1

121 Spear St Ste 500
San Francisco, CA 94105-1581
Phone (888) 201-1937

Other identifiers 1

IdentifierTypeStateIssuer
T296681OtherCASTATE LICENSE

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080712000055 CA Practitioner - Nurse Practitioner 8820160583

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2784CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
One Medical Group, Inc. CurrentSince Jun 27, 2016 Accepting new patients
One Medical Group, Inc CurrentSince Jun 27, 2016 Accepting new patients

Locations

1301 Shoreway Rd
Ste 100
Belmont, CA 94002
Phone (650) 596-7000

1955 Broadway
Ste A
Oakland, CA 94612

900 Veterans Blvd
Ste 150
Redwood City, CA 94063
Phone (650) 298-8774

2900 Whipple Ave
Ste 130
Redwood City, CA 94062
Phone (650) 261-6831

1 Embarcadero Ctr
Ste 1900
San Francisco, CA 94111

130 Sutter St
Fl 2
San Francisco, CA 94104
Phone (415) 529-4522

559 Clay St
#200
San Francisco, CA 94111
Phone (415) 830-4744

1004 Northgate Dr
San Rafael, CA 94903
Phone (415) 590-6150

3151 Crow Canyon Pl
Ste A
San Ramon, CA 94583

Interoperability endpoints

  • Direct secure messaging: peggy.ross@299395540647940.direct.elationemr.com

Organizations & group practices 2

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": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1982742185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR STE 1900",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113723",
            "telephone_number": "888-663-6331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 NORTHGATE DR",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949032502",
            "telephone_number": "888-663-6331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "121 Spear St Ste 500",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941051581",
            "country_code": "US",
            "telephone_number": "888-201-1937",
            "fax_number": "650-227-1107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSS",
        "first_name": "PEGGY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "2784",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "T296681",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

Verify at the official NPI Registry.