DR. FERNANDO ULLOA M.D.
NPI 1124140686
Pediatrics - Adolescent Medicine in San Rafael, CA
NPI Status: Active since April 04, 2007
Contact Information
711 D ST
SUITE 113
SAN RAFAEL, CA
ZIP 94901
Phone: (415) 454-4100
- Individual
- Male
- Pediatrics
- Adolescent Medicine
- PECOS Enrolled
- Opted-Out Medicare
About FERNANDO ULLOA
This page provides the complete NPI Profile along with additional information for Fernando Ulloa, a pediatrician established in San Rafael, California with a medical specialization in Pediatrics, focusing in adolescent medicine . The healthcare provider is registered in the NPI registry with number 1124140686 assigned on April 2007. The practitioner's primary taxonomy code is 2080A0000X with license number G49903 (CA). The provider is registered as an individual and his NPI record was last updated 19 years ago.
- NPI
- 1124140686
- Provider Name
- DR. FERNANDO ULLOA M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 711 D ST SUITE 113 SAN RAFAEL, CA 94901
- Location Phone
- (415) 454-4100
- Mailing Address
- PO BOX 1938 MILL VALLEY, CA 94942
- Mailing Phone
- (415) 454-4100
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 04-04-2007
- Last Update Date
- 07-08-2007
- Code Navigator
A pediatrician like Fernando Ulloa is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Fernando Ulloa opted out of Medicare effective on 06-09-2017 until 06-09-2027. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare but is permitted to order and refer services to other healthcare providers.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pediatrics Adolescent Medicine
- Taxonomy Code
- 2080A0000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- G49903
- License State
- CA
- Taxonomy Description
- A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 00G49903 | MEDICAID (05) | CA |
Medicare Participation & PECOS Enrollment Status
Fernando Ulloa is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 06-09-2017
Opt-Out End Date: 06-09-2027
Eligible to Order and Refer? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Durable Medical Equipment
DME-Medical/Surgical Supplies (DA000N)
Male external catheter, with or without adhesive, disposable, each (HCPCS:A4349)
1 DME suppliers used 11 Medicare Claims 385 Services Paid
Orthotic Devices
DME-Orthotic Devices (DF000N)
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each (HCPCS:A4358)
1 DME suppliers used 11 Medicare Claims 22 Services Paid
Reviews for DR. FERNANDO ULLOA M.D.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1124140686, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 54. The final step is to find the difference between that total and the next multiple of ten (60 - 54 = 6).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 54 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
SAN RAFAEL, CA 94901
SAN RAFAEL, CA 94901
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1124140686, enumerated as an "individual" on April 04, 2007.
The provider is located at 711 D ST SUITE 113 SAN RAFAEL, CA 94901 and the phone number is (415) 454-4100.
Pediatrics with taxonomy code 2080A0000X and a focus in Adolescent Medicine.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
