NPIMap

Individual provider Active NPI

Estevaun Carrion

  • Physician Assistant
  • San Diego, CA
National Provider Identifier
1093209843
Registry record updated Jun 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
55561 Issued in CA
Practice address
200 W Arbor Dr
San Diego, CA 92103-9000
Phone
(800) 926-8273
NPI assigned
Jun 15, 2018
Last updated
Jun 9, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA55561 CA
Physician Assistant 363A00000X 55561 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

Other practice location 1

1415 Ross Ave
El Centro, CA 92243-4306
Phone (760) 339-7100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20181114002892 CA Practitioner - Physician Assistant 7012261845 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

200 W Arbor Dr
San Diego, CA 92103-1920
Phone (858) 249-6753

3855 Health Sciences Dr
La Jolla, CA 92093-1503
Phone (858) 249-6753

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA55561CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Current Accepting new patients
Regents of the University of California CurrentSince May 9, 2021 Accepting new patients
Scripps Health CurrentSince Sep 4, 2018 Accepting new patients
Regents of the University of California Current Accepting new patients
Regents of the University of California CurrentSince May 9, 2021 Accepting new patients
Scripps Health Physician Assistant CurrentSince Sep 4, 2018 Accepting new patients
Regents of the University of California Past Accepting new patients
Regents of the University of California Ucsd Head and Neck Surgery Past Accepting new patients

Locations

1415 Ross Ave
El Centro, CA 92243
Phone (760) 339-4045

3855 Health Sciences Dr
La Jolla, CA 92093
Phone (800) 926-8276

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

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

Interoperability endpoints

  • Direct secure messaging: ecarrion31613@scrippshlth.medalliesdirect.net

Organizations & group practices 11

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 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": "1529020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1093209843",
    "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": "921039000",
            "telephone_number": "800-926-8273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1415 Ross Ave",
            "address_purpose": "LOCATION",
            "city": "El Centro",
            "state": "CA",
            "postal_code": "922434306",
            "country_code": "US",
            "telephone_number": "760-339-7100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARRION",
        "first_name": "ESTEVAUN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-15",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA55561",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "55561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.