JUDAH JOSHUA MIRVISH
NPI 1073045381
Psychiatry & Neurology - Child & Adolescent Psychiatry in San Francisco, CA

Q: What is Judah Mirvish's NPI number?

The NPI number for Judah Mirvish is 1073045381. It was assigned to this individual provider in the NPPES registry on March 28, 2017.

Q: What is Judah Mirvish's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Q: When was this NPI record last updated?

The NPPES record for Judah Mirvish was last updated on January 6, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 28, 2017PECOS Enrolled

939 ELLIS ST FL 5, SAN FRANCISCO, CA 94109(415) 833-2292(702) 529-4030 Get Directions Write a Review

NPPES record last updated: January 6, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jan 6, 2023, Aug 22, 2022, Mar 28, 2017 (3 updates tracked since 2017).

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About Judah Joshua Mirvish NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JUDAH JOSHUA MIRVISH (NPI 1073045381) is an individual child & adolescent psychiatry provider in San Francisco, California, licensed in California (A178097) and active in the NPI registry since March 2017. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1073045381

Entity TypeIndividualMale

Primary Taxonomy2084P0804X

Provider Legal NameJUDAH JOSHUA MIRVISH

Location Address939 ELLIS ST FL 5San Francisco, CA 94109-7714

Mailing Address2120 Funston AveSan Francisco, CA 94116-1903 · (415) 710-2179 · Fax (702) 529-4030

Phone(415) 833-2292

Fax(702) 529-4030

Sole ProprietorNo

Enumeration DateMarch 28, 2017

Last NPPES UpdateJanuary 6, 20233 updates tracked since enumeration

NPPES CertifiedJanuary 6, 2023

✔ NPI 1073045381 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians

Taxonomy Code2084P0804X

License✔ Licensed in CA · A178097

Definition

Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X · License D0086815 (MD)

939 ELLIS ST FL 5, San Francisco, CA 94109

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Judah Joshua Mirvish is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Judah Mirvish reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Permanente Medical Group Inc

1.0 mi

Internal Medicine

2238 GEARY
San Francisco, CA 94116

Reassigned Medicare billing, California enrollment
20,078 clinicians in this Medicare group

NPI 1841373800 (415) 833-2200

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. STACY N KNIGHT PSYD

Psychologist (Clinical Child & Adolescent)

939 ELLIS ST FL 5
SAN FRANCISCO, CA 94109

San Francisco County (415) 833-2292

MRS. CHELSEA DAWN FULLER LMFT

Marriage & Family Therapist

939 ELLIS ST FL 5
SAN FRANCISCO, CA 94109

San Francisco County (415) 833-2292

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Judah Mirvish's NPI number?

The NPI number for Judah Mirvish is 1073045381. It was assigned to this individual provider in the NPPES registry on March 28, 2017.

Where is Judah Mirvish located?

Judah Mirvish practices at 939 Ellis St Fl 5, San Francisco, CA 94109. The listed phone number is (415) 833-2292.

What is Judah Mirvish's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Is Judah Mirvish enrolled in Medicare?

Yes. Judah Mirvish is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Judah Mirvish's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Judah Mirvish reassigns Medicare benefits to Permanente Medical Group Inc (San Francisco, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Judah Mirvish's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Judah Mirvish was last updated on January 6, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.