Individual provider Active NPI

Srinivas Iyengar, MD

  • Ophthalmology Physician
  • Encinitas, CA
National Provider Identifier
1104030055
Registry record updated Oct 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
A105824 Issued in CA
Practice address
477 N El Camino Real
C-308
Encinitas, CA 92024-1328
Phone
(760) 942-9225
Fax
(760) 942-9343
NPI assigned
May 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 6444 KS
Ophthalmology Physician 207W00000X A105824 CA Primary
Ophthalmology Physician 207W00000X ME110731 FL

Addresses

Primary practice location

477 N El Camino Real
C-308
Encinitas, CA 92024-1328

Mailing address

477 N El Camino Real
C-308
Encinitas, CA 92024-1328
Phone (760) 942-9225

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
I20091113000013 CA Practitioner - Ophthalmology 9537207493 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Colorado School of Medicine, Denver, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

477 N El Camino Real
Suite A304
Encinitas, CA 92024-1351
Phone (858) 432-2700

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
105824CAMDDentist
A105824CAMDOphthalmology Physician
6444KSMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Current Accepting new patients
Emergency and Acute Care Medical Corporation CurrentSince Jan 10, 2018 Accepting new patients

Locations

435 H St
Chula Vista, CA 91910
Phone (619) 691-7000

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

Interoperability endpoints

  • Direct secure messaging: siyengar71404@scrippshlth.medalliesdirect.net

Organizations & group practices 3

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": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444694400000",
    "number": "1104030055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "477 N EL CAMINO REAL",
            "address_2": "C-308",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920241328",
            "telephone_number": "760-942-9225",
            "fax_number": "760-942-9343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "477 N EL CAMINO REAL",
            "address_2": "C-308",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920241328",
            "telephone_number": "760-942-9225",
            "fax_number": "760-942-9343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IYENGAR",
        "first_name": "SRINIVAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-10",
        "last_updated": "2015-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "KS",
            "license": "6444",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A105824",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME110731",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encinitas, CA

Sources for this page

Verify at the official NPI Registry.