Active NPI
Mira Maria John, MD
- Critical Care Medicine (Internal Medicine) Physician
- La Jolla, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Medicine (Internal Medicine) Physician
- License
- A196769
- Practice address
- 9300 Campus Point Dr
La Jolla, CA 92037-1300 - Phone
- (800) 926-8273
- NPI assigned
- Mar 25, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | A196769 | CA | |
| Internal Medicine Physician | 207R00000X | MD61153632 | WA | |
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | MD61153632 | WA | |
| Pulmonary Disease Physician | 207RP1001X | A196769 | CA | |
| Hospitalist Physician | 208M00000X | 298729 | NY | |
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | A196769 | CA | Primary |
Addresses
Primary practice location
9300 Campus Point Dr
La Jolla, CA 92037-1300
Mailing address
File 57326
Los Angeles, CA 90074-7326
Phone (800) 926-8273
Other practice location 1
17 E 102nd St
New York, NY 10029-5204
Phone (212) 659-8551
Other practice location 2
550 1st Ave
New York, NY 10016-6402
Phone (212) 263-7300
Other practice location 3
1959 NE Pacific Street
Seattle, WA 98195
Phone (206) 616-8378
Other practice location 4
4011 Talbot Rd S Ste 460
Renton, WA 98055-5791
Phone (425) 690-3484
Other practice location 5
200 W Arbor Dr
San Diego, CA 92103-9000
Phone (800) 926-8273
Other practice location 6
4520 Executive Dr
San Diego, CA 92121-3018
Phone (800) 926-8273
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA, CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Critical Care (Intensivists)
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
200 W Arbor Dr
San Diego, CA 92103-9000
Phone (858) 249-6753
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A196769 | CA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Regents of the University of California | Pulmonary Disease | Current | Accepting new patients |
| Valley Medical Group-Renton | Internal Medicine | Current | Accepting new patients |
| Regents of the University of California | Current | Accepting new patients | |
| Regents of the University of California Ucsd Head and Neck Surgery | Past | Accepting new patients |
Locations
9300 Campus Point Dr
La Jolla, CA 92037
Phone (619) 957-7000
File 57326
Los Angeles, CA 90074
4520 Executive Dr
San Diego, CA 92121
Phone (858) 249-1429
200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754
16850 SE 272nd St
Ste 100
Covington, WA 98042
Phone (253) 395-1971
4011 Talbot Rd S
Ste 460
Renton, WA 98055
Phone (425) 251-5110
Interoperability endpoints
- mjohn105996@direct.valleymed.org
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.
-
- Pulmonary Disease Physician
- San Diego, CA
- NPI 1386762300
-
- Diagnostic Radiology Physician
- San Diego, CA
- NPI 1558463927
-
- Otolaryngology Physician
- San Diego, CA
- NPI 1679509962
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- San Diego, CA
- NPI 1184722779
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722470400000",
"number": "1013448588",
"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": "800-926-8273"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9300 CAMPUS POINT DR",
"city": "LA JOLLA",
"state": "CA",
"postal_code": "920371300",
"telephone_number": "800-926-8273"
}
],
"practiceLocations": [
{
"address_1": "17 E 102nd St",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100295204",
"country_code": "US",
"telephone_number": "212-659-8551",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "550 1st Ave",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100166402",
"country_code": "US",
"telephone_number": "212-263-7300",
"fax_number": "212-263-6022",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1959 NE Pacific Street",
"address_purpose": "LOCATION",
"city": "Seattle",
"state": "WA",
"postal_code": "98195",
"country_code": "US",
"telephone_number": "206-616-8378",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4011 Talbot Rd S Ste 460",
"address_purpose": "LOCATION",
"city": "Renton",
"state": "WA",
"postal_code": "980555791",
"country_code": "US",
"telephone_number": "425-690-3484",
"fax_number": "425-690-9084",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "200 W Arbor Dr",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921039000",
"country_code": "US",
"telephone_number": "800-926-8273",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4520 Executive Dr",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921213018",
"country_code": "US",
"telephone_number": "800-926-8273",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOHN",
"first_name": "MIRA",
"middle_name": "MARIA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-03-25",
"last_updated": "2024-08-01",
"certification_date": "2024-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "A196769",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WA",
"license": "MD61153632",
"primary": false
},
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "WA",
"license": "MD61153632",
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "CA",
"license": "A196769",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "NY",
"license": "298729",
"primary": false
},
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "CA",
"license": "A196769",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in La Jolla, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.