Individual provider Active NPI

Michael N Palanca, M. D.

  • Optometrist
  • San Diego, CA
National Provider Identifier
1033663109
Registry record updated Oct 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD12245 Issued in CA
Practice address
15004 Innovation Dr.
San Diego, CA 92128-3409
Phone
(858) 605-7186
NPI assigned
Aug 6, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 12245 CA
Optometrist 152W00000X OD12245 CA Primary

Addresses

Primary practice location

15004 Innovation Dr.
San Diego, CA 92128-3409

Mailing address

10790 Rancho Bernardo Rd
San Diego, CA 92127-5705
Phone (858) 605-7186

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171025001513 CA Practitioner - Optometry 8224933957 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scripps HealthGroup PAC ID 9234033853, 1,450 clinicians

Practice addresses (Care Compare)

15004 Innovation Dr
San Diego, CA 92128-3498
Phone (858) 487-1800

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OD12245CAMDOptometrist
12245CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Current Accepting new patients
Regents of the University of California CurrentSince Apr 15, 2019 Accepting new patients
Family Health Centers of San Diego, Inc Current Accepting new patients
Scripps Health CurrentSince Jun 3, 2019 Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Oct 19, 2017 Accepting new patients
Scripps Health CurrentSince Jun 3, 2019 Accepting new patients
Regents of the University of California CurrentSince Apr 15, 2019 Accepting new patients
Family Health Centers of San Diego Inc CurrentSince Oct 19, 2017 Accepting new patients
Scripps Health Current Accepting new patients
Scripps Health Current Accepting new patients
University of California Irvine Past Accepting new patients
Scripps Clinic Medical Group Past Accepting new patients

Locations

525 E Main St
El Cajon, CA 92020
Phone (619) 334-3787

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

10862 Calle Verde
La Mesa, CA 91941
Phone (619) 660-5400

File 54433
Los Angeles, CA 90074
Phone (858) 784-5645

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

15004 Innovation Dr
San Diego, CA 92128
Phone (858) 487-1800

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

1809 National Ave
San Diego, CA 92113
Phone (619) 515-2500

10790 Rancho Bernardo Rd
San Diego, CA 92127
Phone (858) 554-2626

Interoperability endpoints

  • Direct secure messaging: mpalanca285415@scrippshlth.medalliesdirect.net

Organizations & group practices 12

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": "1470441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571702400000",
    "number": "1033663109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10790 RANCHO BERNARDO RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275705",
            "telephone_number": "858-605-7186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15004 INNOVATION DR.",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921283409",
            "telephone_number": "858-605-7186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALANCA",
        "first_name": "MICHAEL",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-06",
        "last_updated": "2019-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12245",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OD12245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.