Individual provider Active NPI

Edward William Schumaker, DO

  • Family Medicine Physician
  • Chula Vista, CA
National Provider Identifier
1184616872
Registry record updated May 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A6433 Issued in CA
Practice address
2452 Fenton St
Suite 301
Chula Vista, CA 91914-3599
Phone
(619) 946-4073
NPI assigned
Aug 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A6433 CA Primary

Addresses

Primary practice location

2452 Fenton St
Suite 301
Chula Vista, CA 91914-3599

Mailing address

653 El Portal Dr
Chula Vista, CA 91914-4109
Phone (619) 419-1958

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
I20070815000400 CA Practitioner - Family Practice 4587756903 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastlake Family Medical Inc.Group PAC ID 2961594387, 2 clinicians

Practice addresses (Care Compare)

2452 Fenton St
Suite 301
Chula Vista, CA 91914-4552
Phone (619) 946-4073

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A6433CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eastlake Family Medical Inc. Family Medicine CurrentSince Jan 1, 1996 Accepting new patients
Sharp Chula Vista Medical Center Past Accepting new patients
Scripps Health Past Accepting new patients

Locations

2452 Fenton St
Ste 301
Chula Vista, CA 91914
Phone (619) 946-4073

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ADFDAA/Endpoint/ADFDAA

Organizations & group practices 3

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": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400112000000",
    "number": "1184616872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "653 EL PORTAL DR",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919144109",
            "telephone_number": "619-419-1958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2452 FENTON ST",
            "address_2": "SUITE 301",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919143599",
            "telephone_number": "619-946-4073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHUMAKER",
        "first_name": "EDWARD",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2014-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A6433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

Verify at the official NPI Registry.