Individual provider Active NPI

Bobby S. Korn, M.D.

  • Ophthalmology Physician
  • La Jolla, CA
National Provider Identifier
1174551006
Registry record updated Mar 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
A81749 Issued in CA
Practice address
9500 Gilman Dr
Mail Code 0946
La Jolla, CA 92093-5004
Phone
(858) 534-7402
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X A81749 CA Primary

Addresses

Primary practice location

9500 Gilman Dr
Mail Code 0946
La Jolla, CA 92093-5004

Mailing address

PO Box 232410
Mail Code 0946
San Diego, CA 92193-2410
Phone (858) 249-6748

Other identifiers 2

IdentifierTypeStateIssuer
00A817490OtherCAMEDICAL BOARD
00A817490MedicaidCA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050706000324 CA Practitioner - Ophthalmology 2163468687 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Texas Southwestern Medical School at Dallas, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

200 W Arbor Dr
San Diego, CA 92103-1911
Phone (858) 249-6753

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.77 of 100Reported as group
Quality
84.13
Promoting interoperability
100
Improvement activities
40
Cost
73.88

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A81749CAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince Jul 1, 2005 Accepting new patients
Regents of the University of California Ophthalmology CurrentSince Jul 1, 2005 Accepting new patients
Regents of the University of California Ucsd Head and Neck Surgery Past Accepting new patients
Regents of the University of California Past Accepting new patients

Locations

9415 Campus Point Dr
La Jolla, CA 92093
Phone (619) 543-3000

File 57326
Los Angeles, CA 90074

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

Organizations & group practices 4

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 1

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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489968000000",
    "number": "1174551006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 232410",
            "address_2": "MAIL CODE 0946",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921932410",
            "telephone_number": "858-249-6748",
            "fax_number": "619-543-3183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 GILMAN DR",
            "address_2": "MAIL CODE 0946",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920935004",
            "telephone_number": "858-534-7402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORN",
        "first_name": "BOBBY",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2017-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A81749",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL BOARD",
            "identifier": "00A817490",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A817490",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

Verify at the official NPI Registry.