Individual provider Active NPI

Peter D Yorgin, M.D.

  • Pediatric Nephrology Physician
  • San Diego, CA
National Provider Identifier
1023039831
Registry record updated Oct 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nephrology PhysicianTaxonomy code 2080P0210X
License
G64029 Issued in CA
Practice address
8001 Frost St
Entrance 10
San Diego, CA 92123-2746
Phone
(858) 966-8052
NPI assigned
Jul 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nephrology Physician 2080P0210X G64029 CA Primary
Pediatrics Physician 208000000X G64029 CA

Addresses

Primary practice location

8001 Frost St
Entrance 10
San Diego, CA 92123-2746

Mailing address

3860 Calle Fortunada
Ste #210
San Diego, CA 92123-4802
Phone (858) 309-6303

Other identifiers 1

IdentifierTypeStateIssuer
00G640290MedicaidCA

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
I20050606000452 CA Practitioner - Pediatric MedicinePractitioner - Nephrology 6204879844 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G64029CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rady Children'S Hospital San Diego CurrentSince Jan 20, 2010 Accepting new patients
Rady Children'S Hospital San Diego Pediatrics CurrentSince Jan 20, 2010 Accepting new patients
Children'S Specialists of San Diego - Div of Hem&Onc Pediatrics Past Accepting new patients

Locations

25170 Hancock Ave
Murrieta, CA 92562
Phone (858) 757-3277

3020 Childrens Way
#5137
San Diego, CA 92123

3020 Childrens Way
San Diego, CA 92123
Phone (858) 966-5841

8001 Frost St
#10
San Diego, CA 92123
Phone (858) 966-5811

Interoperability endpoints

  • Direct secure messaging: pyorgin61801@radychildrens.direct-ci.com

Organizations & group practices 3

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": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318550400000",
    "number": "1023039831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3860 CALLE FORTUNADA",
            "address_2": "STE #210",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234802",
            "telephone_number": "858-309-6303",
            "fax_number": "858-309-6301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8001 FROST ST",
            "address_2": "ENTRANCE 10",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921232746",
            "telephone_number": "858-966-8052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YORGIN",
        "first_name": "PETER",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2011-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "CA",
            "license": "G64029",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G64029",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G640290",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.