Michael Jack Coulter, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

D7935901 Issued in CA

Practice address

200 Mercy Circle
Camp Pendleton, CA 92055

Phone

(760) 725-6646

NPI assigned

Jun 8, 2016

Last updated

Aug 23, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Otolaryngology

Education

State University of New York at Stony Brook, School of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

On Call Specialists Medical Group of San Diego IncGroup PAC ID 7911395231, 145 clinicians

Sunset ENT IncGroup PAC ID 0648693770, 5 clinicians

Emergency and Acute Care Medical CorporationGroup PAC ID 9537108279, 431 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Scripps Mercy Hospital Hospital, San Diego, CA, CCN 050077
• Grossmont Hospital Hospital, La Mesa, CA, CCN 050026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Emergency and Acute Care Medical Corporation

  • Emergency Medicine Physician
  • San Diego, CA
  • NPI 1437103942
  Medicare reassignment Care Compare group NPD
• On Call Specialists Medical Group of San Diego, Inc.

  • Specialist
  • San Diego, CA
  • NPI 1962175836
  Medicare reassignment Care Compare group NPD
• Sunset ENT Inc.

  • Otolaryngology Physician
  • San Diego, CA
  • NPI 1689297277
  Medicare reassignment Care Compare group NPD

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

• Grossmont Hospital Corporation

  dba Sharp Grossmont Hospital

  • General Acute Care Hospital
  • La Mesa, CA
  • NPI 1528041811
  Care Compare affiliation
• Scripps Health

  dba Scripps Mercy Hospital

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1659359446
  Care Compare affiliation

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

{
    "created_epoch": "1465344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661212800000",
    "number": "1124477211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 555191",
            "city": "CAMP PENDLETON",
            "state": "CA",
            "postal_code": "920555191",
            "telephone_number": "760-725-6646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MERCY CIRCLE",
            "city": "CAMP PENDLETON",
            "state": "CA",
            "postal_code": "92055",
            "telephone_number": "760-725-6646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COULTER",
        "first_name": "MICHAEL",
        "middle_name": "JACK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-08",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A150427",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "D7935901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clay Arthure Cooper, IDC
• Michelle Marie Cormier, M.D.
• Lee Cornforth, O. D.
• Katherine Lynn Cortez, MD
• Thomas Concannon Cote, SOIDC
• Kelly Hale Court, PSYD
• Darren Joseph Couture, CRNA
• Alissa Cramer, COTA/L
• Gerald Thomas Crollard, RN
• Linda Marie Crowell, LPT

• Otolaryngology Physician in Camp Pendleton, CA
• Providers in Camp Pendleton, CA by specialty
• Otolaryngology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; 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.