NPIMap

Individual provider Active NPI

Stuart B Kipper, M.D.

  • Internal Medicine Physician
  • Vista, CA
National Provider Identifier
1114956570
Registry record updated Apr 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G61129 Issued in CA
Practice address
910 Sycamore Ave
Suite 220
Vista, CA 92081-7832
Phone
(760) 598-1700
Fax
(760) 598-1196
NPI assigned
Jun 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G61129 CA Primary

Addresses

Primary practice location

910 Sycamore Ave
Suite 220
Vista, CA 92081-7832

Mailing address

910 Sycamore Ave
Suite 270
Vista, CA 92081-7832
Phone (760) 598-1700

Other identifiers 3

IdentifierTypeStateIssuer
00G611290MedicaidCA
2598333OtherCAGHI
110048716OtherCARAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101012000067 CA Practitioner - Internal MedicinePractitioner - Geriatric Medicine 9638190606 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
University of California, Geffen School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

700 Garden View CT
Encinitas, CA 92024-2478
Phone (760) 632-1018

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions203

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G61129CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stuart B Kipper MD Inc. Internal Medicine CurrentSince Aug 1, 2011 Accepting new patients
Regents of the University of California Internal Medicine Current Accepting new patients
UC San Diego Health Community Group Past Accepting new patients
Scripps Health Past Accepting new patients

Locations

700 Garden View Ct
Ste 200
Encinitas, CA 92024
Phone (760) 632-1018

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12471/brand/1/csg/1/fhir/r4
  • Direct secure messaging: stuart.kipper.1@12471.direct.athenahealth.com

Organizations & group practices 4

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 4

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": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209513600000",
    "number": "1114956570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 SYCAMORE AVE",
            "address_2": "SUITE 270",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920817832",
            "telephone_number": "760-598-1700",
            "fax_number": "760-598-1196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 SYCAMORE AVE",
            "address_2": "SUITE 220",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920817832",
            "telephone_number": "760-598-1700",
            "fax_number": "760-598-1196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIPPER",
        "first_name": "STUART",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2008-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G61129",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G611290",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "2598333",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110048716",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vista, CA

Sources for this page

Verify at the official NPI Registry.