Individual provider Active NPI

Liza Suzanne Blumenfeld

  • Speech-Language Pathologist
  • San Diego, CA
National Provider Identifier
1053853614
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
10068 Issued in CA
Practice address
200 W Arbor Dr
San Diego, CA 92103-9000
Phone
(800) 926-8273
NPI assigned
Nov 14, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 10068 CA Primary

Addresses

Primary practice location

200 W Arbor Dr
San Diego, CA 92103-9000

Mailing address

PO Box 232410
San Diego, CA 92193-2410

Other practice location 1

8899 University Center Ln Ste 240
San Diego, CA 92122-1039
Phone (858) 657-8590

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170511000848 CA Practitioner - Qualified Speech Language Pathologist 7719264225 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

200 W Arbor Dr
San Diego, CA 92103-9000
Phone (858) 657-7000

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

State licenses

LicenseStateTypeSpecialty
10068CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince May 1, 2023 Accepting new patients
Regents of the University of California Current Accepting new patients
Regents of the University of California CurrentSince May 1, 2023 Accepting new patients
Regents of the University of California Past Accepting new patients

Locations

3855 Health Sciences Dr
La Jolla, CA 92093
Phone (858) 822-6094

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

9333 Genesee Ave
Ste 100
San Diego, CA 92121

8899 University Center Ln
San Diego, CA 92122
Phone (858) 543-7496

8899 University Center Ln
Ste 240
San Diego, CA 92122
Phone (619) 880-6603

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.

NPI Registry JSON

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

{
    "created_epoch": "1479081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1053853614",
    "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": "921039000",
            "telephone_number": "800-926-8273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8899 University Center Ln Ste 240",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921221039",
            "country_code": "US",
            "telephone_number": "858-657-8590",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLUMENFELD",
        "first_name": "LIZA",
        "middle_name": "SUZANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-14",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "10068",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.