Individual provider Active NPI

Barbara Denysiak, M.D.

  • Legal Medicine
  • San Diego, CA
National Provider Identifier
1003085572
Registry record updated Jan 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Legal MedicineTaxonomy code 173000000X
License
A48505 Issued in CA
Practice address
3969 4TH Ave
Ste. 203
San Diego, CA 92103-3165
Phone
(619) 294-6500
Fax
(619) 294-6505
NPI assigned
Feb 28, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Legal Medicine 173000000X A48505 CA Primary

Addresses

Primary practice location

3969 4TH Ave
Ste. 203
San Diego, CA 92103-3165

Mailing address

3969 4TH Ave
Ste. 203
San Diego, CA 92103-3165
Phone (619) 294-6500

Other identifiers 1

IdentifierTypeStateIssuer
A48505OtherCALICENSE

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
I20060824000285 CA Practitioner - General PracticePractitioner - Family Practice 3577566900 Reassigns benefits to 1 organization
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medicus MD IncGroup PAC ID 3375727555, 2 clinicians

Practice addresses (Care Compare)

3969 4TH Ave
Suite 203
San Diego, CA 92103-3165
Phone (619) 294-6500

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medicus MD Inc CurrentSince Aug 24, 2006 Accepting new patients
Scripps Health Current Accepting new patients
Scripps Health Past Accepting new patients
Scripps Health Past Accepting new patients

Locations

4077 5th Ave
San Diego, CA 92103
Phone (619) 260-7245

3969 4th Ave
San Diego, CA 92103
Phone (619) 291-6191

3969 4th Ave
Ste 203
San Diego, CA 92103
Phone (619) 294-6500

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: bdenysiak80948@scrippshlth.medalliesdirect.net

Organizations & group practices 4

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": "1204156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294963200000",
    "number": "1003085572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3969 4TH AVE",
            "address_2": "STE. 203",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921033165",
            "telephone_number": "619-294-6500",
            "fax_number": "619-294-6505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3969 4TH AVE",
            "address_2": "STE. 203",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921033165",
            "telephone_number": "619-294-6500",
            "fax_number": "619-294-6505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENYSIAK",
        "first_name": "BARBARA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-28",
        "last_updated": "2011-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "CA",
            "license": "A48505",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "A48505",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.