Active NPI
Peter D Yorgin, M.D.
- Pediatric Nephrology Physician
- San Diego, CA
National Provider Identifier
1023039831
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nephrology Physician
- License
- G64029
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G640290 | Medicaid | CA |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G64029 | CA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rady Children'S Hospital San Diego | Current | Accepting new patients | |
| Rady Children'S Hospital San Diego | Pediatrics | Current | 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
- 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.
-
- Pediatrics Physician
- San Diego, CA
- NPI 1669617197
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- San Diego, CA
- NPI 1851303994
-
- Pediatric Hematology & Oncology Physician
- San Diego, CA
- NPI 1649337114
Pediatrics
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2011; 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.