Individual provider Active NPI

Shagun Kumari Bhatia, MD, MSCR

  • Ophthalmology Physician
  • La Jolla, CA
National Provider Identifier
1104237353
Registry record updated Mar 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
A154902 Issued in CA
Practice address
9415 Campus Point Dr
La Jolla, CA 92093-1350
Phone
(588) 534-2020
NPI assigned
May 9, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X A154902 CA Primary

Addresses

Primary practice location

9415 Campus Point Dr
La Jolla, CA 92093-1350

Mailing address

PO Box 232410
San Diego, CA 92193-2410

Other practice location 1

40 Temple St
New Haven, CT 06510
Phone (203) 785-2020

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
I20180723002198 CA Practitioner - Ophthalmology 6002195393 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Emory University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rady Children'S Hospital San DiegoGroup PAC ID 3971677493, 164 clinicians

Practice addresses (Care Compare)

3010 Childrens Way
San Diego, CA 92123-4223
Phone (858) 576-1700

3020 Children'S Way
San Diego, CA 92123-4223
Phone (858) 576-1700

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A154902CAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince Jun 1, 2018 Accepting new patients
Regents of the University of California Ophthalmology CurrentSince Jun 1, 2018 Accepting new patients
Marilyn Kaufhold, M.D., a Medical Corporation Past Accepting new patients
Regents of the University of California Past Accepting new patients

Locations

477 N El Camino Real
Ste D302
Encinitas, CA 92024

9415 Campus Point Dr
La Jolla, CA 92093
Phone (619) 543-3000

File 57326
Los Angeles, CA 90074

3020 Childrens Way
San Diego, CA 92123
Phone (858) 966-5841

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

7910 Frost St
Ste 200
San Diego, CA 92123
Phone (858) 278-8300

3020 Childrens Way
#5003
San Diego, CA 92123
Phone (858) 309-6300

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": "1399593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553126400000",
    "number": "1104237353",
    "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": "9415 CAMPUS POINT DR",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920931350",
            "telephone_number": "588-534-2020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "40 Temple St",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "06510",
            "country_code": "US",
            "telephone_number": "203-785-2020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BHATIA",
        "first_name": "SHAGUN",
        "middle_name": "KUMARI",
        "credential": "MD, MSCR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-09",
        "last_updated": "2019-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A154902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

Verify at the official NPI Registry.