Individual provider Active NPI

Kristin Moosmann Engorn, M.D.

  • Obstetrics & Gynecology Physician
  • San Diego, CA
National Provider Identifier
1184923336
Registry record updated Feb 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
M84853 Issued in MD
Practice address
7695 Cardinal CT Ste 240
San Diego, CA 92123-3357
Phone
(858) 277-9378
NPI assigned
Mar 26, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X M84853 MD Primary

Addresses

Primary practice location

7695 Cardinal CT Ste 240
San Diego, CA 92123-3357

Mailing address

6565 N Charles St
Suite 406
Baltimore, MD 21204-6800
Phone (443) 849-2568

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
I20171023002433 CA Practitioner - Obstetrics/Gynecology 0749596690 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
West Coast OB/GYN, Inc.Group PAC ID 1850315235, 15 clinicians

Practice addresses (Care Compare)

7695 Cardinal CT
Suite 240
San Diego, CA 92123-3357
Phone (858) 277-9378

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M84853MDMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sharp Memorial Hospital Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kengorn32402@sharphealthcare.direct-ci.com

Organizations & group practices 2

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 2

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": "1301097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582848000000",
    "number": "1184923336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6565 N CHARLES ST",
            "address_2": "SUITE 406",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212046800",
            "telephone_number": "443-849-2568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7695 CARDINAL CT STE 240",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921233357",
            "telephone_number": "858-277-9378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGORN",
        "first_name": "KRISTIN",
        "middle_name": "MOOSMANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-26",
        "last_updated": "2020-02-28",
        "certification_date": "2020-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MD",
            "license": "M84853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.