Individual provider Active NPI

Soheil Niku, M.D.

  • Diagnostic Radiology Physician
  • San Diego, CA
National Provider Identifier
1003985177
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A72423 Issued in CA
Practice address
12580 Carmel Creek Rd
#52
San Diego, CA 92130-2392
Phone
(619) 322-0341
Fax
(858) 509-0341
NPI assigned
Nov 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X A72423 CA Primary

Addresses

Primary practice location

12580 Carmel Creek Rd
#52
San Diego, CA 92130-2392

Mailing address

12580 Carmel Creek Rd
#52
San Diego, CA 92130-2392
Phone (619) 322-0341

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
I20040714001115 CA Practitioner - Diagnostic Radiology 5890774814 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Rush Medical College of Rush University, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Radiology Consultants Medical Group IncGroup PAC ID 4688572639, 8 clinicians

Practice addresses (Care Compare)

255 N Elm St
Suite 102
Escondido, CA 92025-3431
Phone (760) 520-8500

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
72423CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Radiology Consultants Medical Group, Inc Diagnostic Radiology CurrentSince Aug 30, 2014 Accepting new patients
Midcoast Imaging Medical Group Diagnostic Radiology PastSince Feb 16, 2020 Accepting new patients
Silicon Valley Medical Imaging Inc a Medical Corporation PastSince Jun 8, 2009 Accepting new patients
Pacific Imaging Consultants, a Medical Group, Inc. Diagnostic Radiology Past Accepting new patients

Locations

255 N Elm St
Ste 102
Escondido, CA 92025
Phone (760) 743-3873

225 E 2nd Ave
Ste 104
Escondido, CA 92025
Phone (858) 815-2550

15725 Pomerado Rd
Ste 101
Poway, CA 92064

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": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003985177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12580 CARMEL CREEK RD",
            "address_2": "#52",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921302392",
            "telephone_number": "619-322-0341",
            "fax_number": "858-509-0341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12580 CARMEL CREEK RD",
            "address_2": "#52",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921302392",
            "telephone_number": "619-322-0341",
            "fax_number": "858-509-0341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIKU",
        "first_name": "SOHEIL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A72423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.