Individual provider Active NPI

Paula Grayson

  • Pediatrics Physician
  • San Diego, CA
National Provider Identifier
1003955303
Registry record updated May 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
G72924 Issued in CA
Practice address
15004 Innovation Dr
San Diego, CA 92128-3491
Phone
(858) 605-7969
NPI assigned
Feb 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X G72924 CA Primary

Addresses

Primary practice location

15004 Innovation Dr
San Diego, CA 92128-3491

Mailing address

10790 Rancho Bernardo Rd
San Diego, CA 92127-5705
Phone (858) 605-7969

Other identifiers 1

IdentifierTypeStateIssuer
00G729240MedicaidCA

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
I20070514000629 CA Practitioner - Pediatric Medicine 1850498551 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G72924CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Current Accepting new patients
Monica Perlman MD Inc. CurrentSince Oct 1, 2022 Accepting new patients
UC San Diego Health - Rancho Family Medical Group Past Accepting new patients
Sharp Memorial Hospital Past Accepting new patients
Rady Children's Hospital San Diego Past Accepting new patients
Regents of the University of California Past Accepting new patients
Scripps Clinic Medical Group, Inc Past Accepting new patients
Scripps Clinic Medical Group Past Accepting new patients
Scripps Health Past Accepting new patients

Locations

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

9850 Genesee Ave
Ste 320
La Jolla, CA 92037
Phone (858) 864-9800

10790 Rancho Bernardo Rd
San Diego, CA 92127
Phone (858) 554-2626

3900 5th Ave
Ste 110
San Diego, CA 92103
Phone (619) 291-5474

2790 Truxtun Rd
Ste 120A
San Diego, CA 92106
Phone (619) 222-1253

3737 Moraga Ave
Ste B103
San Diego, CA 92117
Phone (858) 799-0855

Interoperability endpoints

  • Direct secure messaging: pgrayson5688@scrippshlth.medalliesdirect.net

Organizations & group practices 9

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": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651536000000",
    "number": "1003955303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10790 RANCHO BERNARDO RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275705",
            "telephone_number": "858-605-7969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15004 INNOVATION DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921283491",
            "telephone_number": "858-605-7969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAYSON",
        "first_name": "PAULA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G72924",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G729240",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.