Active NPI
Nathaly Maria Coromoto Sweeney, M.D.
- Neonatal-Perinatal Medicine Physician
- La Jolla, CA
National Provider Identifier
1164572632
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal-Perinatal Medicine Physician
- License
- A110761
- Practice address
- 9300 Campus Point Dr # Mc7774
La Jolla, CA 92037-1300 - Phone
- (619) 543-3759
- Fax
- (619) 543-3812
- NPI assigned
- Jan 10, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | P20264 | MD | |
| Pediatric Cardiology Physician | 2080P0202X | A110761 | CA | |
| Pediatric Emergency Medicine (Pediatrics) Physician | 2080P0204X | D67515 | MD | |
| Neonatal-Perinatal Medicine Physician | 2080N0001X | A110761 | CA | Primary |
Addresses
Primary practice location
9300 Campus Point Dr # Mc7774
La Jolla, CA 92037-1300
Mailing address
9300 Campus Point Dr # Mc7774
La Jolla, CA 92037-1300
Phone (619) 543-3759
Other practice location 1
3020 Childrens Way
San Diego, CA 92123-4223
Phone (858) 576-1700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 018764000 | Medicaid | MD |
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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160729002276 | CA | Order and Referring Only - Pediatric Medicine | 7012084908 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P20264 | MD | MD | Pediatrics Physician |
| A110761 | CA | MD | Pediatric Cardiology Physician |
| D67515 | MD | MD | Pediatric Emergency Medicine (Pediatrics) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rady Children'S Hospital San Diego | Past | Accepting new patients | |
| Lucile Salter Packard Children'S Hospital at Stanford | Past | Accepting new patients | |
| Regents of the University of California | Past | Accepting new patients | |
| Marilyn Kaufhold, M.D., a Medical Corporation | Past | Accepting new patients | |
| Palomar Health | Past | Accepting new patients |
Organizations & group practices 5
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.
-
- Children's Hospital
- Palo Alto, CA
- NPI 1467442749
-
- Children's Hospital
- San Diego, CA
- NPI 1336359389
-
- General Acute Care Hospital
- Escondido, CA
- NPI 1457321317
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- San Diego, CA
- NPI 1851303994
-
- Pharmacy
- San Diego, CA
- NPI 1598786576
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1164572632",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9300 CAMPUS POINT DR # MC7774",
"city": "LA JOLLA",
"state": "CA",
"postal_code": "920371300",
"telephone_number": "619-543-3759",
"fax_number": "619-543-3812"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9300 CAMPUS POINT DR # MC7774",
"city": "LA JOLLA",
"state": "CA",
"postal_code": "920371300",
"telephone_number": "619-543-3759",
"fax_number": "619-543-3812"
}
],
"practiceLocations": [
{
"address_1": "3020 Childrens Way",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921234223",
"country_code": "US",
"telephone_number": "858-576-1700",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SWEENEY",
"first_name": "NATHALY",
"middle_name": "MARIA COROMOTO",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-10",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MD",
"license": "P20264",
"primary": false
},
{
"code": "2080P0202X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Cardiology",
"state": "CA",
"license": "A110761",
"primary": false
},
{
"code": "2080P0204X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Emergency Medicine",
"state": "MD",
"license": "D67515",
"primary": false
},
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "CA",
"license": "A110761",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "018764000",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}
Other providers in La Jolla, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.