Individual provider Active NPI

Andi Docktor, MA, CCC-SLP

  • Speech-Language Pathologist
  • San Diego, CA
National Provider Identifier
1073150801
Registry record updated Nov 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
26061 Issued in CA
Practice address
8899 University Center LN Ste 240
San Diego, CA 92122-1039
Phone
(858) 249-4070
NPI assigned
Nov 27, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2019

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 26061 CA Primary

Addresses

Primary practice location

8899 University Center LN Ste 240
San Diego, CA 92122-1039

Mailing address

8899 University Center LN Ste 240
San Diego, CA 92122-1039
Phone (858) 249-4070

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230523000686 CA Practitioner - Qualified Speech Language Pathologist 5890151567 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2016
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, 2,047 clinicians

Practice addresses (Care Compare)

200 W Arbor Dr
San Diego, CA 92103-3109
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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
26061CAMDPharmacist

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 Ucsd Head and Neck Surgery Past 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

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

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

9333 Genesee Ave
Ste 100
San Diego, CA 92121

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1574812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574812800000",
    "number": "1073150801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8899 UNIVERSITY CENTER LN STE 240",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921221039",
            "telephone_number": "858-249-4070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8899 UNIVERSITY CENTER LN STE 240",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921221039",
            "telephone_number": "858-249-4070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOCKTOR",
        "first_name": "ANDI",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-27",
        "last_updated": "2019-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "26061",
            "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 Nov 27, 2019; 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.