Individual provider Active NPI

Kathryn Mizera O'Neil, M.D.

  • Emergency Medicine Physician
  • San Diego, CA
National Provider Identifier
1114280765
Registry record updated Apr 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD.52162 Issued in AL
Practice address
34800 Bob Wilson Dr
San Diego, CA 92134-1098
Phone
(773) 501-9673
NPI assigned
Jun 19, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 23708 MS
Emergency Medicine Physician 207P00000X MD.52162 AL Primary
Emergency Medicine Physician 207P00000X 23241 NV

Addresses

Primary practice location

34800 Bob Wilson Dr
San Diego, CA 92134-1098

Mailing address

2000 Pepperell Pkwy
Opelika, AL 36801-5452

Other practice location 1

2000 Pepperell Pkwy
Opelika, AL 36801-5452
Phone (334) 749-3411

Other names 1

  • Kathryn Mizera Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, NV, AL3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20200803001629 GA Practitioner - Emergency Medicine 6406168889 Reassigns benefits to 2 organizations
I20230607002508 NV Practitioner - Emergency Medicine 6406168889 Reassigns benefits to 1 organization
I20260602002543 AL Practitioner - Emergency Medicine 6406168889 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Rush Medical College of Rush University, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Team Physicians of Nevada-Scherr, PCGroup PAC ID 4082844147, 16 clinicians

Practice addresses (Care Compare)

2000 Pepperell Pkwy
Opelika, AL 36801-5452
Phone (334) 528-6610

801 E Williams Ave
Fallon, NV 89406-3052
Phone (775) 423-3151

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.52162ALMDEmergency Medicine Physician
23241NVMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nevada Emergency Physicians PLLC Emergency Medicine Current Accepting new patients
Georgia Emergency Physician Specialists Emergency Medicine CurrentSince Aug 1, 2020 Accepting new patients
Nevada Emergency Physicians PLLC Emergency Medicine CurrentSince Jul 17, 2023 Accepting new patients
Team Physicians of Nevada-Scherr, P.C. Emergency Medicine CurrentSince Jun 1, 2023 Accepting new patients
Nevada Emergency Physicians PLLC Emergency Medicine CurrentSince Jul 17, 2023 Accepting new patients

Locations

4700 Waters Ave
Savannah, GA 31404
Phone (912) 273-1100

459 Highway 119 S
Springfield, GA 31329
Phone (912) 754-0200

801 E Williams Ave
Fallon, NV 89406
Phone (775) 423-0310

6500 Longley Ln
Reno, NV 89511
Phone (775) 331-7000

2375 E Prater Way
Sparks, NV 89434
Phone (775) 331-7000

Organizations & group practices 7

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1340064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775520000000",
    "number": "1114280765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 PEPPERELL PKWY",
            "city": "OPELIKA",
            "state": "AL",
            "postal_code": "368015452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34800 BOB WILSON DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921341098",
            "telephone_number": "773-501-9673"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2000 Pepperell Pkwy",
            "address_purpose": "LOCATION",
            "city": "Opelika",
            "state": "AL",
            "postal_code": "368015452",
            "country_code": "US",
            "telephone_number": "334-749-3411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'NEIL",
        "first_name": "KATHRYN",
        "middle_name": "MIZERA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-19",
        "last_updated": "2026-04-07",
        "certification_date": "2026-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MS",
            "license": "23708",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AL",
            "license": "MD.52162",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NV",
            "license": "23241",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "MIZERA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.