Samuel O Etchie, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A53857 Issued in CA

Practice address

7200 Parkway Dr Ste 113
La Mesa, CA 91942-1534

Phone

(619) 337-0455

Fax

(619) 667-6059

NPI assigned

Aug 9, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Psychiatry

Education

Other, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Paradise Valley Hospital Hospital, National City, CA, CCN 050024
• Grossmont Hospital Hospital, La Mesa, CA, CCN 050026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: setchie78109@scrippshlth.medalliesdirect.net

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.

• Samuel O T Etchie MD Inc

  • Psychiatry Physician
  • La Mesa, CA
  • NPI 1346669157
  Medicare reassignment NPD Authorized official
• Emergency and Acute Care Medical Corporation

  • Emergency Medicine Physician
  • San Diego, CA
  • NPI 1437103942
  Medicare reassignment NPD
• Scripps Health

  • Multi-Specialty Clinic/Center
  • La Jolla, CA
  • NPI 1275899072
  Medicare reassignment NPD
• Michelle Stewart Nursing, Inc.

  • Psychiatric/Mental Health Nurse Practitioner
  • La Mesa, CA
  • NPI 1174412142
  NPD
• Scripps Health

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1487928891
  NPD
• Scripps Health

  • Home Health Agency
  • San Diego, CA
  • NPI 1578556114
  NPD
• Scripps Health

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • La Jolla, CA
  • NPI 1619108503
  NPD

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

• Grossmont Hospital Corporation

  • General Acute Care Hospital
  • La Mesa, CA
  • NPI 1528041811
  Care Compare affiliation
• Prime Healthcare Paradise Valley LLC

  • General Acute Care Hospital
  • Chula Vista, CA
  • NPI 1194898486
  Care Compare affiliation
• Prime Healthcare Paradise Valley LLC

  • General Acute Care Hospital
  • National City, CA
  • NPI 1356410351
  Care Compare affiliation

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534982400000",
    "number": "1124039052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7770 REGENTS RD",
            "address_2": "# 130",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921221937",
            "telephone_number": "619-337-0455",
            "fax_number": "619-667-6059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7200 PARKWAY DR STE 113",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919421534",
            "telephone_number": "619-337-0455",
            "fax_number": "619-667-6059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETCHIE",
        "first_name": "SAMUEL",
        "middle_name": "O",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2018-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A53857",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A538570",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Esquivel-Parker
• Danyah Essa
• Jerson Derek Esteban, BSN RN
• Georgiana Estrada
• Leticia Estrella
• Michelle Etherington, LVN
• Caitlin Eubanks, LCSW
• Keane Evangelista
• Richard B Evans, D.D.S.
• Evolve Growth Initiatives LLC

• Psychiatry Physician in La Mesa, CA
• Providers in La Mesa, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2018; 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.