Individual provider Active NPI

William Fornaciari, M.D.

  • Emergency Medicine Physician
  • San Diego, CA
National Provider Identifier
1083682546
Registry record updated Jan 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
G69338 Issued in CA
Practice address
7901 Frost St
San Diego, CA 92123-2701
Phone
(619) 541-3400
Fax
(619) 285-5999
NPI assigned
Mar 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X G69338 CA Primary

Addresses

Primary practice location

7901 Frost St
San Diego, CA 92123-2701

Mailing address

440 Stevens Ave Ste 150
Solana Beach, CA 92075-2058
Phone (858) 759-4765

Other identifiers 1

IdentifierTypeStateIssuer
00G693380MedicaidCA

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
I20060317000560 CA Practitioner - Emergency Medicine 5092722900 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Southern California Keck School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sharp Rees-Stealy Medical Group IncGroup PAC ID 8628972759, 872 clinicians

Practice addresses (Care Compare)

10243 Genetic Ctr Dr
San Diego, CA 92121-6310
Phone (858) 499-2600

Merit-based Incentive Payment System (MIPS)

Final score
88.67 of 100Reported as group
Quality
81.04
Promoting interoperability
99
Improvement activities
40
Cost
82.04

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G69338CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Feb 5, 2018 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc Emergency Medicine CurrentSince Feb 5, 2018 Accepting new patients
Emergency Services Medical Corporation Emergency Medicine CurrentSince Apr 1, 2006 Accepting new patients
Sharp Rees-Stealy Medical Center Past Accepting new patients
Sharp Memorial Hospital Past Accepting new patients

Locations

7901 Frost St
San Diego, CA 92123
Phone (619) 541-3400

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

10243 Genetic Center Dr
San Diego, CA 92121
Phone (858) 499-2704

Interoperability endpoints

  • Direct secure messaging: wfornaciari32272@sharphealthcare.direct-ci.com

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": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516060800000",
    "number": "1083682546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 STEVENS AVE STE 150",
            "city": "SOLANA BEACH",
            "state": "CA",
            "postal_code": "920752058",
            "telephone_number": "858-759-4765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 FROST ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921232701",
            "telephone_number": "619-541-3400",
            "fax_number": "619-285-5999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORNACIARI",
        "first_name": "WILLIAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-10",
        "last_updated": "2018-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G69338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G693380",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.