Individual provider Active NPI

Benjamin Dylan Fiore, M.D

  • Gastroenterology Physician
  • San Diego, CA
National Provider Identifier
1114330404
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
A192499 Issued in CA
Practice address
Naval Medical Ctr
34800 Bob Wilson Dr.
San Diego, CA 92134-5000
Phone
(860) 394-9462
NPI assigned
Jun 4, 2014
Last updated
May 27, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Gastroenterology Physician 207RG0100X A192499 CA Primary

Addresses

Primary practice location

Naval Medical Ctr
34800 Bob Wilson Dr.
San Diego, CA 92134-5000

Mailing address

Naval Medical Ctr
34800 Bob Wilson Dr.
San Diego, CA 92134-5000

Other practice location 1

8860 Center Dr Ste 420
LA Mesa, CA 91942-7001
Phone (619) 469-5400

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, OR2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20240219001086 CA Practitioner - Gastroenterology 4385994581 Reassigns benefits to 3 organizations
I20240315003702 OR Practitioner - Gastroenterology 4385994581 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4647 Zion Ave
San Diego, CA 92120-2507
Phone (619) 528-5000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A192499CAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Feb 21, 2025 Accepting new patients
Southern California Permanente Medical Group CurrentSince Feb 21, 2025 Accepting new patients
Emergency and Acute Care Medical Corporation CurrentSince May 10, 2024 Accepting new patients
Peacehealth Medical Group CurrentSince May 30, 2024 Accepting new patients
Asante CurrentSince Nov 30, 2024 Accepting new patients
Peacehealth CurrentSince Mar 25, 2024 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Asante CurrentSince Nov 30, 2024 Accepting new patients
Peacehealth Past Accepting new patients

Locations

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

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

4077 5th Ave
San Diego, CA 92103
Phone (619) 260-7245

4647 Zion Ave
San Diego, CA 92120
Phone (619) 528-3038

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

4010 Aerial Way
Eugene, OR 97402
Phone (541) 242-8300

2825 E Barnett Rd
Medford, OR 97504
Phone (541) 282-6770

2801 NW Mercy Dr
Ste 350
Roseburg, OR 97471
Phone (541) 222-2700

3377 Riverbend Dr
Ste 200
Springfield, OR 97477

Organizations & group practices 10

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.

Hospital & facility affiliations 3

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": "1401840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1114330404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NAVAL MEDICAL CTR",
            "address_2": "34800 BOB WILSON DR.",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921345000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NAVAL MEDICAL CTR",
            "address_2": "34800 BOB WILSON DR.",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921345000",
            "telephone_number": "860-394-9462"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8860 Center Dr Ste 420",
            "address_purpose": "LOCATION",
            "city": "LA Mesa",
            "state": "CA",
            "postal_code": "919427001",
            "country_code": "US",
            "telephone_number": "619-469-5400",
            "fax_number": "619-464-1311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FIORE",
        "first_name": "BENJAMIN",
        "middle_name": "DYLAN",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-04",
        "last_updated": "2025-05-27",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A192499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4647 Zion Ave",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921202507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.