Brian Rebolledo, M.D.

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

A140481 Issued in CA

Practice address

10710 N Torrey Pines Rd
La Jolla, CA 92037-1035

Phone

(858) 554-7980

NPI assigned

May 19, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Sports MedicineAlso: Orthopedic Surgery

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Scripps HealthGroup PAC ID 9234033853, 1,450 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lorian Health Home health agency, San Diego, CA, CCN 058113
• Scripps Green Hospital Hospital, La Jolla, CA, CCN 050424
• Scripps Mercy Hospital Hospital, San Diego, CA, CCN 050077
• Scripps Memorial Hospital - Encinitas Hospital, Encinitas, CA, CCN 050503
• Scripps Memorial Hospital la Jolla Hospital, La Jolla, CA, CCN 050324

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: brebolledo37147@scrippshlth.medalliesdirect.net

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.

• Scripps Health

  • Multi-Specialty Clinic/Center
  • La Jolla, CA
  • NPI 1275899072
  Medicare reassignment Care Compare group NPD
• Scripps Health

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1487928891
  NPD
• Scripps Health

  • Home Health Agency
  • San Diego, CA
  • NPI 1578556114
  NPD
• Scripps Health

  • General Acute Care Hospital
  • La Jolla, CA
  • NPI 1841277704
  NPD
• Scripps Clinic Medical Group

  • Multi-Specialty Clinic/Center
  • San Diego, CA
  • NPI 1124003280
  NPD (past)
• Scripps Health

  • General Acute Care Hospital
  • La Jolla, CA
  • NPI 1841233780
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lorian Home Systems, Inc.

  • Home Health Agency
  • San Diego, CA
  • NPI 1447318092
  Care Compare affiliation
• Scripps Health

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1659359446
  Care Compare affiliation
• Scripps Health

  • General Acute Care Hospital
  • Encinitas, CA
  • NPI 1700829199
  Care Compare affiliation
• Scripps Health

  • General Acute Care Hospital
  • La Jolla, CA
  • NPI 1841233780
  Care Compare affiliation
• Scripps Health

  • General Acute Care Hospital
  • La Jolla, CA
  • NPI 1841277704
  Care Compare affiliation

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

{
    "created_epoch": "1305763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576108800000",
    "number": "1104119494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10790 RANCHO BERNARDO RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275705",
            "telephone_number": "858-554-7980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10710 N TORREY PINES RD",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371035",
            "telephone_number": "858-554-7980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REBOLLEDO",
        "first_name": "BRIAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-19",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "CA",
            "license": "A140481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cedar Raymond
• Hazel Isabella Raymond
• Kathaleen R Reagan, LPCC
• Ann C Rearden, M.D.
• Reavivo Marriage and Family Therapy Inc
• Mark Rechnic, MD
• Priya Reddy, MD
• David C. Redfield, M.D.
• Kristie Lynn Reed, PHD
• William Henry Reed, MD

• Sports Medicine (Orthopaedic Surgery) Physician in La Jolla, CA
• Providers in La Jolla, CA by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.