Irene C Coletsos, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

C196263 Issued in CA

Practice address

5333 Mission Center Rd Ste 105
San Diego, CA 92108-1347

Phone

(619) 997-4510

Fax

(619) 984-5440

NPI assigned

Aug 7, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Community Research Foundation Inc

  • Community/Behavioral Health Agency
  • San Diego, CA
  • NPI 1952328700
  Medicare reassignment NPD
• Mental Health Systems, Inc.

  • Community/Behavioral Health Agency
  • San Diego, CA
  • NPI 1760431670
  Medicare reassignment NPD
• Community Research Foundation Inc

  • Community/Behavioral Health Agency
  • San Diego, CA
  • NPI 1871365684
  NPD
• Mental Health Systems, Inc.

  • Community/Behavioral Health Agency
  • Fresno, CA
  • NPI 1720745169
  NPD

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

{
    "created_epoch": "1186444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1013108869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5333 MISSION CENTER RD STE 105",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081347",
            "telephone_number": "619-997-4510",
            "fax_number": "619-984-5440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5333 MISSION CENTER RD STE 105",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081347",
            "telephone_number": "619-997-4510",
            "fax_number": "619-984-5440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLETSOS",
        "first_name": "IRENE",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-07",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "256535",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "C196263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Ross Coleman, MD
• Tiffany Coleman, RN
• Sage Coler, PSYD
• Lisa Marie Coles, M.D.
• Shane Hunter Coles, MD
• Joelle Marie Coletta, M.D.
• Justine Munsayac Coliflores, ATC
• Desiree Colin
• Giovanna Colin
• Kenneth F Colina, MD

• Psychiatry Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.