Individual provider Active NPI

Carolyn Sylvia Quintero, MD

  • Pediatrics Physician
  • Spring Valley, CA
National Provider Identifier
1023033156
Registry record updated Nov 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
G77053 Issued in CA
Practice address
8788 Jamacha Rd
Spring Valley, CA 91977-4035
Phone
(619) 515-2300
NPI assigned
Jul 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2017

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 G77053 CA Primary

Addresses

Primary practice location

8788 Jamacha Rd
Spring Valley, CA 91977-4035

Mailing address

823 Gateway Center Way
San Diego, CA 92102-4541
Phone (619) 906-4623

Other identifiers 1

IdentifierTypeStateIssuer
77053OtherCALIC

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
I20180509000509 CA Practitioner - Pediatric Medicine 3072877539 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G77053CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North County Health Project Inc CurrentSince Mar 31, 2018 Accepting new patients
North County Health Project Inc CurrentSince Mar 31, 2018 Accepting new patients
North County Health Project Inc Current Accepting new patients
Rady Children'S Hospital San Diego Past Accepting new patients
Sharp Coronado Hospital and Healthcare Center Past Accepting new patients
Tri-City Hospital Past Accepting new patients
Scripps Health Past Accepting new patients
Regents of the University of California Past Accepting new patients

Locations

150 Valpreda Rd
San Marcos, CA 92069
Phone (619) 736-6700

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: cquintero313268@direct.ochin.org

Organizations & group practices 8

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510531200000",
    "number": "1023033156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 GATEWAY CENTER WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921024541",
            "telephone_number": "619-906-4623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8788 JAMACHA RD",
            "city": "SPRING VALLEY",
            "state": "CA",
            "postal_code": "919774035",
            "telephone_number": "619-515-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINTERO",
        "first_name": "CAROLYN",
        "middle_name": "SYLVIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2017-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G77053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC",
            "identifier": "77053",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring Valley, CA

Sources for this page

Verify at the official NPI Registry.