Individual provider Active NPI

Lauren Kathleen Meyerson, PA-C

  • Physician Assistant
  • San Diego, CA
National Provider Identifier
1124805536
Registry record updated Mar 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
9095 Rio San Diego Dr Ste 425
San Diego, CA 92108-1679
Phone
(858) 455-5524
Fax
(858) 587-9377
NPI assigned
Sep 11, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecologic Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VX0201X PA64136 CA
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

9095 Rio San Diego Dr Ste 425
San Diego, CA 92108-1679

Mailing address

9401 Jeronimo Rd
Irvine, CA 92618-1908

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240319004033 CA Practitioner - Physician Assistant 8022455500 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
South Coast Gynecologic Oncology IncGroup PAC ID 1557366556, 7 clinicians

Practice addresses (Care Compare)

9095 Rio San Diego Dr
Suite 425
San Diego, CA 92108-1679
Phone 8584555524205

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
64136CAMDProsthodontist
PA64136CAMDGynecologic Oncology Physician

Organizations & group practices 1

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.

Hospital & facility affiliations 5

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": "1694390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743120000000",
    "number": "1124805536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9401 JERONIMO RD",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926181908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9095 RIO SAN DIEGO DR STE 425",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081679",
            "telephone_number": "858-455-5524",
            "fax_number": "858-587-9377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYERSON",
        "first_name": "LAUREN",
        "middle_name": "KATHLEEN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-11",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0201X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "CA",
            "license": "PA64136",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.