Individual provider Active NPI

Berenice Jimenez

  • Family Medicine Physician
  • San Diego, CA
National Provider Identifier
1043707631
Registry record updated Oct 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A163575 Issued in CA
Practice address
200 W Arbor Dr # Mc8809
San Diego, CA 92103-1911
Phone
(619) 543-2165
Fax
(619) 543-5996
NPI assigned
Apr 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A163575 CA Primary

Addresses

Primary practice location

200 W Arbor Dr # Mc8809
San Diego, CA 92103-1911

Mailing address

1400 E Palomar St
Chula Vista, CA 91913-1800
Phone (619) 543-2165

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
I20210721001791 CA Practitioner - Family Practice 6406259993 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, San Diego School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sharp Rees-Stealy Medical Group IncGroup PAC ID 8628972759, 872 clinicians

Practice addresses (Care Compare)

10670 Wexford St
San Diego, CA 92131-3940
Phone (858) 621-4002

1400 E Palomar St
Chula Vista, CA 91913-1800
Phone (858) 499-2600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.67 of 100Reported as group
Quality
81.04
Promoting interoperability
99
Improvement activities
40
Cost
82.04

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A163575CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sharp Rees-Stealy Medical Group, Inc Family Medicine CurrentSince Jul 12, 2021 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Jul 12, 2021 Accepting new patients
Sharp Rees-Stealy Medical Center Past Accepting new patients
Sharp Memorial Hospital Past Accepting new patients

Locations

1400 E Palomar St
Chula Vista, CA 91913
Phone (619) 397-3077

525 Third Ave
Chula Vista, CA 91910
Phone (619) 585-4050

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

5651 Copley Dr
Ste A
San Diego, CA 92111
Phone (858) 262-6109

Interoperability endpoints

  • Direct secure messaging: bjimenez34215@sharphealthcare.direct-ci.com

Organizations & group practices 4

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": "1524009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1043707631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E PALOMAR ST",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919131800",
            "telephone_number": "619-543-2165",
            "fax_number": "619-543-5996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR # MC8809",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921031911",
            "telephone_number": "619-543-2165",
            "fax_number": "619-543-5996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "BERENICE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-18",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A163575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.