Jeremy Hodson Pettus

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

A106382 Issued in CA

Practice address

200 W Arbor Dr
San Diego, CA 92103-9001

Phone

(858) 657-1636

Fax

(858) 657-1626

NPI assigned

Jun 21, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Endocrinology

Education

Boston University School of Medicine, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Regents of the University of CaliforniaGroup PAC ID 3577476761, 2,047 clinicians

Practice addresses (Care Compare)

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Regents of the University of California

  • Pain Medicine (Anesthesiology) Physician
  • San Diego, CA
  • NPI 1376646869
  Medicare reassignment Care Compare group NPD
• Regents of the University of California

  • Internal Medicine Physician
  • San Diego, CA
  • NPI 1508968751

  Endocrinology, Diabetes & Metabolism

  NPD
• Regents of the University of California

  • Diagnostic Radiology Physician
  • San Diego, CA
  • NPI 1558463927
  NPD
• Regents of the University of California

  • Pharmacy
  • San Diego, CA
  • NPI 1598786576
  NPD (past)
• Regents of the University of California Ucsd Head and Neck Surgery

  • Otolaryngology Physician
  • San Diego, CA
  • NPI 1679509962
  NPD (past)

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

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519689600000",
    "number": "1225234982",
    "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": "921039001",
            "telephone_number": "858-657-1636",
            "fax_number": "858-657-1626"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 W Arbor Dr",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921039001",
            "country_code": "US",
            "telephone_number": "619-543-1849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETTUS",
        "first_name": "JEREMY",
        "middle_name": "HODSON",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-21",
        "last_updated": "2018-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CA",
            "license": "A106382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Pettingill, CCLS
• Beth Suzanne Pettis, PMHNP
• Gabrielle Pettit
• James R. Pettit, M.D.
• Shannon Pettit
• Asia Ruby Petty, B.A.
• Emily Jones Petty, PA-C
• Gregory Petty, PA-C
• Michael Peugh, IDC
• Kari Peviani, DAOM

• Endocrinology, Diabetes & Metabolism Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Endocrinology, Diabetes & Metabolism Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2018; 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.