Individual provider Active NPI

Leonard A Jurkowski, MD

  • Family Medicine Physician
  • San Diego, CA
National Provider Identifier
1093758757
Registry record updated Feb 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C43217 Issued in CA
Practice address
10605 Scripps Poway Pkwy Ste C
San Diego, CA 92131-3925
Phone
(858) 622-0554
Fax
(858) 622-1417
NPI assigned
Jun 13, 2006
Last updated
Feb 10, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X C43217 CA Primary

Addresses

Primary practice location

10605 Scripps Poway Pkwy Ste C
San Diego, CA 92131-3925

Mailing address

10605 Scripps Poway Pkwy Ste C
San Diego, CA 92131-3925
Phone (858) 622-0554

Other practice location 1

3830 Valley Centre Dr Ste 702
San Diego, CA 92130-3307
Phone (858) 720-0554

Other identifiers 1

IdentifierTypeStateIssuer
00C432170OtherCABLUE CROSS

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
I20090629000181 CA Practitioner - Family Practice 1850442005 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jurkowski Medical CorporationGroup PAC ID 7911155304, 16 clinicians
Two Zeds Medical CorporationGroup PAC ID 7810291291, 14 clinicians

Practice addresses (Care Compare)

10605 Scripps Poway Pkwy
Suite Bandc
San Diego, CA 92131-3925
Phone (858) 622-0554

3830 Valley Centre Dr
San Diego, CA 92130-3307
Phone (858) 720-0554

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C43217CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Two Zeds Medical Corporation Family Medicine CurrentSince Jul 14, 2015 Accepting new patients
Scripps Health Current Accepting new patients
Jurkowski Medical Corporation Family Medicine CurrentSince Jun 30, 2012 Accepting new patients
Scripps Health Past Accepting new patients

Locations

10605 Scripps Poway Pkwy
San Diego, CA 92131
Phone (858) 622-0554

10605 Scripps Poway Pkwy
Ste B
San Diego, CA 92131
Phone (858) 622-0554

10605 Scripps Poway Pkwy
Ste C
San Diego, CA 92131
Phone (858) 622-0554

3830 Valley Centre Dr
Ste 702
San Diego, CA 92130
Phone (858) 720-0554

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: ljurkowski81166@scrippshlth.medalliesdirect.net

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581292800000",
    "number": "1093758757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10605 SCRIPPS POWAY PKWY STE C",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921313925",
            "telephone_number": "858-622-0554",
            "fax_number": "858-622-1417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10605 SCRIPPS POWAY PKWY STE C",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921313925",
            "telephone_number": "858-622-0554",
            "fax_number": "858-622-1417"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3830 Valley Centre Dr Ste 702",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921303307",
            "country_code": "US",
            "telephone_number": "858-720-0554",
            "fax_number": "858-720-0553",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JURKOWSKI",
        "first_name": "LEONARD",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "C43217",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "00C432170",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.