Individual provider Active NPI

Jamie S John, CRNA

  • Certified Registered Nurse Anesthetist
  • San Diego, CA
National Provider Identifier
1184602153
Registry record updated Sep 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN705825 Issued in CA
Practice address
200 W Arbor Dr
San Diego, CA 92103-9000
Phone
(619) 543-5720
NPI assigned
Jan 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN705825 CA Primary

Addresses

Primary practice location

200 W Arbor Dr
San Diego, CA 92103-9000

Mailing address

PO Box 232410
San Diego, CA 92193-2410

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071019000622 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2062455199 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regents of the University of CaliforniaGroup PAC ID 3577476761, 2,047 clinicians
Equanimity Anesthesia Professional CorporationGroup PAC ID 9436684461, 7 clinicians
Samantha Polikowski Anesthesia IncGroup PAC ID 1951742543, 36 clinicians

Practice addresses (Care Compare)

200 W Arbor Dr
San Diego, CA 92103-9000
Phone (800) 926-8273

488 E Valley Pkwy
Suite 100
Escondido, CA 92025-3300
Phone (760) 546-4386

8705 Complex Dr
Suite 202
San Diego, CA 92123-1401
Phone (858) 302-2502

9300 Campus Point Dr
La Jolla, CA 92037-1300
Phone (619) 543-1899

Hospital & facility affiliations

  • UC San Diego Health Hillcrest - Hillcrest Med Ctr Hospital, San Diego, CA, CCN 050025

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN705825CAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Samantha Polikowski Anesthesia Inc Nurse Anesthetist, Certified Registered CurrentSince Nov 8, 2025 Accepting new patients
Regents of the University of California Nurse Anesthetist, Certified Registered CurrentSince Jul 31, 2007 Accepting new patients
Equanimity Anesthesia Professional Corporation CurrentSince Dec 8, 2024 Accepting new patients
Regents of the University of California CurrentSince Jul 31, 2007 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

835 Third Ave
Ste A
Chula Vista, CA 91911
Phone (619) 425-7755

488 E Valley Pkwy
Ste 100
Escondido, CA 92025
Phone (760) 546-4386

25405 Hancock Ave
Ste 103
Murrieta, CA 92562
Phone (909) 698-4670

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

6655 Alvarado Rd
San Diego, CA 92120
Phone (619) 229-3130

8705 Complex Dr
Ste 202
San Diego, CA 92123
Phone (858) 302-2502

Organizations & group practices 6

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": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505865600000",
    "number": "1184602153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 232410",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921932410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000",
            "telephone_number": "619-543-5720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHN",
        "first_name": "JAMIE",
        "middle_name": "S",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-09",
        "last_updated": "2017-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "RN705825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.