Mariam C Ajmal, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95017543 Issued in CA

Practice address

9663 Tierra Grande St Ste 101
San Diego, CA 92126-4569

Phone

(858) 547-0077

NPI assigned

Dec 8, 2021

Last updated

Dec 8, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Del Sur HealthcareGroup PAC ID 1850827395, 61 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Del Sur Healthcare

  • Geriatric Medicine (Internal Medicine) Physician
  • El Cajon, CA
  • NPI 1891515953
  Medicare reassignment Care Compare group NPD
• Bay View Health Solutions

  • Geriatric Medicine (Internal Medicine) Physician
  • Campbell, CA
  • NPI 1508665779
  Medicare reassignment NPD
• Geri Connection

  • Family Medicine Physician
  • Poway, CA
  • NPI 1447976907
  Medicare reassignment NPD
• Myndfull Care California PC

  • Internal Medicine Physician
  • San Diego, CA
  • NPI 1912699703
  Medicare reassignment NPD
• Myndfull Care Management California PC

  • Clinic/Center
  • San Diego, CA
  • NPI 1770206435
  Medicare reassignment NPD
• Senior Medical Associates, Inc.

  • Geriatric Medicine (Internal Medicine) Physician
  • San Diego, CA
  • NPI 1629253505
  Medicare reassignment NPD
• California Care Wellness Medical Center Inc.

  • Internal Medicine Physician
  • San Diego, CA
  • NPI 1447874516
  NPD
• Advantage Health Systems

  • Community Based Hospice Care Agency
  • San Diego, CA
  • NPI 1235414343
  NPD (past)

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

{
    "created_epoch": "1638921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1104585090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17015 BERNARDO CENTER DR APT A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921282593",
            "telephone_number": "818-536-3573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9663 TIERRA GRANDE ST STE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921264569",
            "telephone_number": "858-547-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AJMAL",
        "first_name": "MARIAM",
        "middle_name": "C",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-08",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95017543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Ajani
• Michael Ajao, M.D.
• Ajay D. Amin D.D.S. Inc. (Lighthouse Dental)
• Toluwalase Ayodele Ajayi, MD
• Ajm Anesthesia,Inc
• Veeral Haresh Ajmera, M.D.
• Zena M Ajou, MSW, ASW
• Elisabeth Marie Akamine, OTR
• Akane Institute of Allergy, Asthma & Sleep Medicine
• Malia Akapito

• Family Nurse Practitioner in San Diego, CA
• Providers in San Diego, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; 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.