North County Ear Nose & Throat Head & Neck Surgey Inc

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

G30908 Issued in CA

Legal business name

NORTH COUNTY EAR NOSE & THROAT HEAD & NECK SURGEY INC

Practice address

3909 Waring Rd Ste a
Oceanside, CA 92056-4455

Phone

(760) 726-2440

Fax

(760) 726-0644

NPI assigned

Jun 19, 2006

Organization subpart

No

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

Authorized official

Name

Julie Ann Berry, MD

Title

President

Phone

(760) 726-2440

Specialties & licenses 1

Addresses

Other names 1

• Marc J. Lebovits, MD, Inc. Former legal business name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kayva Lauren Crawford

  • Otolaryngology/Facial Plastic Surgery Physician
  • Del Mar, CA
  • NPI 1396241824
  Medicare reassignment Care Compare group NPD
• Amit Date, MD, MBA

  • Otolaryngology Physician
  • San Diego, CA
  • NPI 1831311984
  Medicare reassignment Care Compare group NPD
• Anton Kushnaryov, M.D.

  • Otolaryngology Physician
  • Oceanside, CA
  • NPI 1023246089
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706659200000",
    "number": "1124063482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3909 WARING RD STE A",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920564455",
            "telephone_number": "760-726-2440",
            "fax_number": "760-726-0644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3909 WARING RD STE A",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920564455",
            "telephone_number": "760-726-2440",
            "fax_number": "760-726-0644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH COUNTY EAR NOSE & THROAT HEAD & NECK SURGEY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-19",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A",
        "authorized_official_last_name": "BERRY",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-726-2440",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "G30908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marc J. Lebovits, MD, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Otolaryngology Physician in Oceanside, CA
• Providers in Oceanside, CA by specialty
• Otolaryngology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.