Individual provider Active NPI

Neil Maitra

  • Cardiovascular Disease Physician
  • La Jolla, CA
National Provider Identifier
1073142675
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
A186167 Issued in CA
Practice address
9898 Genesee Ave
La Jolla, CA 92037-1205
Phone
(858) 824-5333
NPI assigned
Apr 6, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Cardiovascular Disease Physician 207RC0000X A186167 CA Primary

Addresses

Primary practice location

9898 Genesee Ave
La Jolla, CA 92037-1205

Mailing address

10790 Rancho Bernardo Rd
San Diego, CA 92127-5705
Phone (858) 824-5333

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
I20240920003447 CA Practitioner - Cardiovascular Disease (Cardiology) 8123569803 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of Missouri, Kansas City, School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scripps HealthGroup PAC ID 9234033853, 1,450 clinicians

Practice addresses (Care Compare)

9898 Genesee Ave
La Jolla, CA 92037-1205
Phone (858) 455-9100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A186167CAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Current Accepting new patients
Scripps Health CurrentSince Sep 30, 2024 Accepting new patients
Scripps Health CurrentSince Sep 30, 2024 Accepting new patients
Scripps Health Current Accepting new patients
Scripps Clinic Medical Group Past Accepting new patients

Locations

10666 N Torrey Pines Rd
Fl 2
La Jolla, CA 92037
Phone (858) 554-8122

10666 N Torrey Pines Rd
La Jolla, CA 92037
Phone (858) 554-2626

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

9898 Genesee Ave
La Jolla, CA 92037
Phone (858) 824-5222

File 54433
Los Angeles, CA 90074
Phone (858) 784-5645

10790 Rancho Bernardo Rd
San Diego, CA 92127
Phone (858) 554-2626

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": "1586131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1073142675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10790 RANCHO BERNARDO RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275705",
            "telephone_number": "858-824-5333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9898 GENESEE AVE",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371205",
            "telephone_number": "858-824-5333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAITRA",
        "first_name": "NEIL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-06",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A186167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

Verify at the official NPI Registry.