Individual provider Active NPI

Jesse Raia Qualliotine, MD

  • Otolaryngology Physician
  • San Diego, CA
National Provider Identifier
1003239948
Registry record updated Jul 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
A151988 Issued in CA
Practice address
200 W Arbor Dr
San Diego, CA 92103-9000
Phone
(800) 926-8273
Fax
(888) 539-8781
NPI assigned
Jan 29, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X A151988 CA Primary

Addresses

Primary practice location

200 W Arbor Dr
San Diego, CA 92103-9000

Mailing address

PO Box 232410
San Diego, CA 92193-2410
Phone (176) 080-9154

Other practice location 1

1825 4th St Fl 5
San Francisco, CA 94143-2350
Phone (415) 514-6952

Other practice location 2

600 N Wolfe St
Baltimore, MD 21287-2109
Phone (410) 955-5000

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
I20190503001258 CA Practitioner - OtolaryngologyPractitioner - Other (Physician)Practitioner - General Practice 9739421165 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Johns Hopkins University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regents of the University of CaliforniaGroup PAC ID 3577476761, 2,047 clinicians

Practice addresses (Care Compare)

200 W Arbor Dr
San Diego, CA 92103-3109
Phone (858) 657-7000

Hospital & facility affiliations

  • UC San Diego Health Hillcrest - Hillcrest Med Ctr Hospital, San Diego, CA, CCN 050025

Merit-based Incentive Payment System (MIPS)

Final score
90.77 of 100Reported as group
Quality
84.13
Promoting interoperability
100
Improvement activities
40
Cost
73.88

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A151988CAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California Current Accepting new patients
University of California SFGH Medical Group CurrentSince Apr 15, 2022 Accepting new patients
University of California San Francisco CurrentSince Jun 22, 2022 Accepting new patients
UCSF Medical Group Business Services CurrentSince Jun 22, 2022 Accepting new patients
University of California San Francisco CurrentSince Jun 22, 2022 Accepting new patients
Family Health Centers of San Diego, Inc Otolaryngology Current Accepting new patients
Family Health Centers of San Diego, Inc Otolaryngology CurrentSince Feb 18, 2019 Accepting new patients
University of California San Francisco Current Accepting new patients
Family Health Centers of San Diego, Inc Otolaryngology CurrentSince Feb 18, 2019 Accepting new patients
UCSF Medical Group Business Services Otolaryngology CurrentSince Jun 22, 2022 Accepting new patients
Regents of the University of California - Ucsd Medical Group CurrentSince Sep 1, 2023 Accepting new patients
Regents of the University of California CurrentSince Sep 1, 2023 Accepting new patients
University of California SFGH Medical Group CurrentSince Apr 15, 2022 Accepting new patients
Regents of the University of California Past Accepting new patients
Regents of the University of California Ucsd Head and Neck Surgery Otolaryngology Past Accepting new patients
University of California San Francisco Past Accepting new patients

Locations

3855 Health Sciences Dr
La Jolla, CA 92093
Phone (858) 822-6094

9350 Campus Point Dr
La Jolla, CA 92037
Phone (858) 657-0583

200 W Arbor Dr
#8895
San Diego, CA 92103
Phone (619) 543-1967

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

16950 Via Tazon
San Diego, CA 92127
Phone (858) 521-2265

6655 Alvarado Rd
San Diego, CA 92120
Phone (619) 229-3130

1809 National Ave
San Diego, CA 92113
Phone (619) 515-2500

1001 Potrero Ave
San Francisco, CA 94110
Phone (415) 206-2305

1001 Potrero Ave
Rm 3A20
San Francisco, CA 94110
Phone (415) 206-8806

1825 4th St
Fl 5
San Francisco, CA 94143
Phone (415) 353-2101

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

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

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1390953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689292800000",
    "number": "1003239948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 232410",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921932410",
            "telephone_number": "176-080-9154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000",
            "telephone_number": "800-926-8273",
            "fax_number": "888-539-8781"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1825 4th St Fl 5",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941432350",
            "country_code": "US",
            "telephone_number": "415-514-6952",
            "fax_number": "415-885-7711",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "600 N Wolfe St",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212872109",
            "country_code": "US",
            "telephone_number": "410-955-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUALLIOTINE",
        "first_name": "JESSE",
        "middle_name": "RAIA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-01-29",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A151988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.