Susan P Detwiler, MD

Primary specialty

Dermatopathology PhysicianTaxonomy code 207ND0900X

License

G75321 Issued in CA

Practice address

7110 Caminito Pepino
La Jolla, CA 92037-5721

Phone

(858) 539-7300

Fax

(858) 539-7305

NPI assigned

Jul 7, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 5

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

Specialty

DermatologyAlso: Pathology

Education

University of California, Geffen School of Medicine, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatologist Medical Group of North County IncGroup PAC ID 7315849981, 19 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sdetwiler31833@scrippshlth.medalliesdirect.net

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.

• Dermatologist Medical Group of North County, Inc

  • Dermatology Physician
  • Oceanside, CA
  • NPI 1538191077
  Medicare reassignment Care Compare group NPD
• Susan P Detwiler MD Inc

  • Clinical Medical Laboratory
  • La Jolla, CA
  • NPI 1487687414
  NPD (past) Authorized official
• Susan P Detwiler MD Inc

  • Clinical Medical Laboratory
  • La Jolla, CA
  • NPI 1962611350
  NPD (past) Authorized official
• Scripps Health

  dba Scripps Hospital Medical Services

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1487928891
  NPD
• Scripps Health

  dba Scripps Memorial Hospital La Jolla

  • General Acute Care Hospital
  • La Jolla, CA
  • NPI 1841277704
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240876800000",
    "number": "1184656290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7076 CAMINITO VALVERDE",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920375723",
            "telephone_number": "858-539-7300",
            "fax_number": "858-539-7305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7110 CAMINITO PEPINO",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920375721",
            "telephone_number": "858-539-7300",
            "fax_number": "858-539-7305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETWILER",
        "first_name": "SUSAN",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2009-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "G75321",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "CA",
            "license": "G75321",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G753212",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA",
            "identifier": "00G753213",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA",
            "identifier": "00G753214",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "070017499",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LAB25100F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Colin Andrew Depp, PH.D.
• Damian Philip Derienzo, MD
• Katrina Derry, PHARM.D.
• Milli Desai, MD, MAS, MHS
• Sara R Deskin, N.P
• Eliana Judith Deutsch, NP
• Craig B Dever, D.D.S.
• Janet L. Dewees
• Sean Edward Dewolf, MD
• Achal Dhupa, MD

• Dermatopathology Physician in La Jolla, CA
• Providers in La Jolla, CA by specialty
• Dermatopathology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2009; 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.
• 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.