Matthew Jerome McGinniss, PHD FACMG

Primary specialty

Ph.D. Medical GeneticsTaxonomy code 170100000X

License

DRN 9 Issued in CA

Practice address

9410 Carroll Park Dr
San Diego, CA 92121-5201

Phone

(858) 882-5986

Fax

(858) 410-6822

NPI assigned

Jun 22, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Prometheus Laboratories Inc.

  • Clinical Medical Laboratory
  • San Diego, CA
  • NPI 1073642641
  NPD (past)

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

{
    "created_epoch": "1182470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023214319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15485 ANDORRA WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921291107",
            "telephone_number": "858-882-5986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9410 CARROLL PARK DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921215201",
            "telephone_number": "858-882-5986",
            "fax_number": "858-410-6822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGINNISS",
        "first_name": "MATTHEW",
        "middle_name": "JEROME",
        "name_prefix": "Dr.",
        "credential": "PHD FACMG",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "170100000X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Ph.D. Medical Genetics",
            "state": "CA",
            "license": "ABMG-96135",
            "primary": false
        },
        {
            "code": "170100000X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Ph.D. Medical Genetics",
            "state": "CA",
            "license": "DRN 9",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL GENETICS PHD",
            "identifier": "ABMG-96135",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CL GENETIC MOLECULAR BIOL",
            "identifier": "DRN9",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa J McGinn, LMFT
• Micayla Kenzie McGinn, MOT, OTR/L
• Becky Lynn McGinnis
• Heather McGinnis
• Barry Eugene McGinnis, Jr. Jr., PA
• Gail Marie McGiven, MFT
• Shawn McGivern
• Robert Lawrence McGlenn, PH.D.
• Catherine Lynn McGloin
• Samantha Ciara McGlone

• Ph.D. Medical Genetics in San Diego, CA
• Providers in San Diego, CA by specialty
• Ph.D. Medical Genetics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.