NPIMap

Individual provider Active NPI

Etienne Schonbach, MD

  • Ophthalmology Physician
  • San Diego, CA
National Provider Identifier
1073040580
Registry record updated Mar 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
A172673 Issued in CA
Practice address
200 W Arbor Dr
San Diego, CA 92103-9000
Phone
(800) 926-8273
NPI assigned
May 15, 2017
Last updated
Mar 24, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X A172673 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
Phone (800) 926-8273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230918000083 MS Practitioner - Ophthalmology 9739583774 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clay County Medical CorporationGroup PAC ID 4789649609, 36 clinicians

Practice addresses (Care Compare)

187 Medical Ctr Dr
West Point, MS 39773-0428
Phone (662) 492-3175

830 S Gloster
North Ms Med Ctr Sleep Lab
Tupelo, MS 38801-4934
Phone (662) 377-3258

830 S Gloster St
Tupelo, MS 38801-4934

830 S Gloster St 3Rd FL E Tower
Tupelo, MS 38801-4934

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery78

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30430MSMDPsychologist
A172673CAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clay County Medical Corporation Ophthalmology CurrentSince Sep 17, 2024 Accepting new patients
North Mississippi Medical Center, Inc. CurrentSince Jul 6, 2023 Accepting new patients
North Mississippi Medical Center Current Accepting new patients
Clay County Medical Corporation Current Accepting new patients
Clay County Medical Corporation CurrentSince Sep 17, 2024 Accepting new patients
Clay County Medical Corporation Current Accepting new patients
North Mississippi Medcial Center, Inc. CurrentSince Jul 6, 2023 Accepting new patients
North Mississippi Medical Center Inc Current Accepting new patients
North Mississippi Medical Center Past Accepting new patients
Clay County Medical Corporation Past Accepting new patients

Locations

808 Varsity Dr
Tupelo, MS 38801
Phone (662) 377-2386

830 S Gloster St
Tupelo, MS 38801
Phone (662) 377-3136

150 Medical Center Dr
West Point, MS 39773
Phone (601) 494-2321

187 Medical Center Dr
West Point, MS 39773
Phone (662) 492-3175

Interoperability endpoints

  • Direct secure messaging: etienneschonbach@nmhs.medalliesdirect.net

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1494806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648080000000",
    "number": "1073040580",
    "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",
            "telephone_number": "800-926-8273"
        },
        {
            "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": [],
    "basic": {
        "last_name": "SCHONBACH",
        "first_name": "ETIENNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-15",
        "last_updated": "2022-03-24",
        "certification_date": "2022-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A172673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.