Individual provider Active NPI

Nicholas William Wettersten, M.D.

  • Advanced Heart Failure and Transplant Cardiology Physician
  • San Diego, CA
National Provider Identifier
1063701068
Registry record updated Jun 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Heart Failure and Transplant Cardiology PhysicianTaxonomy code 207RA0001X
License
A122511 Issued in CA
Practice address
200 W Arbor Dr
San Diego, CA 92103
Phone
(858) 657-8630
NPI assigned
Mar 31, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Heart Failure and Transplant Cardiology Physician 207RA0001X A122511 CA 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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180702003571 CA Practitioner - Advanced Heart Failure and Transplant Cardiology 8325318025 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Advanced Heart Failure and Transplant Cardiology
Education
University of California, Davis School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Regents of the University of CaliforniaGroup PAC ID 3577476761, shared by 18 NPIs, 2,047 clinicians

Practice addresses (Care Compare)

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

4510 Executive Dr
San Diego, CA 92121-3021
Phone (800) 926-8273

9300 Campus Point Dr
La Jolla, CA 92037-1300
Phone (858) 657-7000

9350 Campus Point Dr
La Jolla, CA 92037-1300
Phone (858) 657-7000

9434 Medical Ctr Dr
La Jolla, CA 92037-1337
Phone (800) 926-8273

9444 Medical Ctr Dr
La Jolla, CA 92037-1337
Phone (800) 926-8273

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

State licenses

LicenseStateTypeSpecialty
A122511CAMDAdvanced Heart Failure and Transplant Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince May 14, 2018 Accepting new patients
Regents of the University of California Current Accepting new patients
Regents of the University of California CurrentSince May 14, 2018 Accepting new patients
Regents of the University of California - Ucsd Medical Group CurrentSince May 14, 2018 Accepting new patients
Regents of the University of California Current Accepting new patients
Regents of the University of California Current Accepting new patients
Regents of the University of California Ucsd Head and Neck Surgery Past Accepting new patients

Locations

9434 Medical Center Dr
La Jolla, CA 92037
Phone (800) 926-8276

9434 Medical Center Dr
Fl 1
La Jolla, CA 92037
Phone (619) 543-6980

41011 California Oaks Rd
Ste 104
Murrieta, CA 92562

35900 Bob Hope Dr
Ste 257
Rancho Mirage, CA 92270
Phone (760) 321-2500

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

Organizations & group practices 7

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": "1301529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528848000000",
    "number": "1063701068",
    "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": "858-657-8630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WETTERSTEN",
        "first_name": "NICHOLAS",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-31",
        "last_updated": "2018-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Advanced Heart Failure and Transplant Cardiology",
            "state": "CA",
            "license": "A122511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.