Individual provider Active NPI

Omonigho A. Aisagbonhi, MD, PHD

  • Anatomic Pathology & Clinical Pathology Physician
  • San Diego, CA
National Provider Identifier
1043571045
Registry record updated Aug 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
L-251735 Issued in MA
Practice address
200 W Arbor Dr
San Diego, CA 92103
Phone
(858) 657-7000
NPI assigned
Jun 6, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X L-251735 MA Primary

Addresses

Primary practice location

200 W Arbor Dr
San Diego, CA 92103

Mailing address

PO Box 232410
San Diego, CA 92193-2410

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
I20180928002259 CA Practitioner - Pathology 9133372360 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Vanderbilt University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regents of the University of CaliforniaGroup PAC ID 3577476761, 2,047 clinicians

Practice addresses (Care Compare)

200 W Arbor Dr
San Diego, CA 92103-1920
Phone (858) 249-6753

Hospital & facility affiliations

  • UC San Diego Health Hillcrest - Hillcrest Med Ctr Hospital, San Diego, CA, CCN 050025

Merit-based Incentive Payment System (MIPS)

Final score
90.77 of 100Reported as group
Quality
84.13
Promoting interoperability
100
Improvement activities
40
Cost
73.88

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L-251735MAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California Anatomic Pathology & Clinical Pathology CurrentSince Jul 21, 2018 Accepting new patients
Regents of the University of California Current Accepting new patients
Regents of the University of California CurrentSince Jul 21, 2018 Accepting new patients
Regents of the University of California Ucsd Head and Neck Surgery Past Accepting new patients
Regents of the University of California Past Accepting new patients

Locations

9444 Medical Center Dr
La Jolla, CA 92037
Phone (858) 249-1206

9300 Campus Point Dr
La Jolla, CA 92037
Phone (619) 957-7000

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1338940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534723200000",
    "number": "1043571045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 232410",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921932410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92103",
            "telephone_number": "858-657-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AISAGBONHI",
        "first_name": "OMONIGHO",
        "middle_name": "A.",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-06",
        "last_updated": "2018-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MA",
            "license": "L-251735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.