Individual provider Active NPI

Mina Kyrollus Ghobrial

  • Critical Care Medicine (Anesthesiology) Physician
  • San Diego, CA
National Provider Identifier
1003304833
Registry record updated Feb 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Anesthesiology) PhysicianTaxonomy code 207LC0200X
License
A192546 Issued in CA
Practice address
200 W Arbor Dr
San Diego, CA 92103-9000
Phone
(800) 926-8273
Fax
(888) 539-8781
NPI assigned
Apr 26, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X D95321 MD
Emergency Medicine Physician 207P00000X A192546 CA
Critical Care Medicine (Anesthesiology) Physician 207LC0200X A192546 CA Primary

Addresses

Primary practice location

200 W Arbor Dr
San Diego, CA 92103-9000

Mailing address

File 57326
Los Angeles, CA 90074-7326
Phone (858) 249-6748

Other practice location 1

600 N Wolfe St
Baltimore, MD 21264-1059
Phone (410) 933-1340

Other practice location 2

1364 Clifton Rd NE
Atlanta, GA 30322-1059
Phone (404) 433-5290

Other identifiers 1

IdentifierTypeStateIssuer
D95321OtherMDMD 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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240123001054 CA Practitioner - Critical Care (Intensivists) 5395096713 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)
Education
Geisel School of Medicine at Dartmouth, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regents of the University of CaliforniaGroup PAC ID 3577476761, shared by 18 NPIs, 2,047 clinicians

Practice addresses (Care Compare)

200 W Arbor Dr
San Diego, CA 92103-9000
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
83.31 of 100Reported as group
Quality
73.89
Promoting interoperability
100
Improvement activities
40
Cost
70.47

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A192546CAMDEmergency Medicine Physician
D95321MDMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California Emergency Medicine Current Accepting new patients
Regents of the University of California CurrentSince Dec 10, 2023 Accepting new patients
Regents of the University of California Emergency Medicine CurrentSince Feb 1, 2024 Accepting new patients
Regents of the University of California CurrentSince May 8, 2024 Accepting new patients
Regents of the University of California Critical Care Medicine CurrentSince Dec 10, 2023 Accepting new patients
Regents of the University of California Ucsd Head and Neck Surgery Past Accepting new patients
Regents of the University of California Past Accepting new patients

Locations

1415 Ross Ave
El Centro, CA 92243
Phone (760) 339-4045

9300 Campus Point Dr
La Jolla, CA 92037
Phone (619) 957-7000

File 57326
Los Angeles, CA 90074

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

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

Interoperability endpoints

  • Direct secure messaging: mghobrial843650@direct.hopkinsmedicine.org

Organizations & group practices 7

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.

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": "1524700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707868800000",
    "number": "1003304833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FILE 57326",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900747326",
            "telephone_number": "858-249-6748"
        },
        {
            "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": "600 N Wolfe St",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212641059",
            "country_code": "US",
            "telephone_number": "410-933-1340",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1364 Clifton Rd NE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303221059",
            "country_code": "US",
            "telephone_number": "404-433-5290",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GHOBRIAL",
        "first_name": "MINA",
        "middle_name": "KYROLLUS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-26",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MD",
            "license": "D95321",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A192546",
            "primary": false
        },
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "CA",
            "license": "A192546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD LICENSE",
            "identifier": "D95321",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.