Individual provider Active NPI

Joy Marie Miedema, PA-C

  • Physician Assistant
  • Temecula, CA
National Provider Identifier
1225319676
Registry record updated Feb 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA21777 Issued in CA
Practice address
29645 Rancho California Rd
Temecula, CA 92591-6200
Phone
(951) 695-7228
NPI assigned
Aug 30, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA21777 CA Primary

Addresses

Primary practice location

29645 Rancho California Rd
Temecula, CA 92591-6200

Mailing address

2428 Teaberry GLN
Escondido, CA 92027-3580

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140603002639 CA Practitioner - Physician Assistant 0840413217 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Scripps HealthGroup PAC ID 9234033853, 1,450 clinicians

Practice addresses (Care Compare)

2176 Salk Ave
Carlsbad, CA 92008-7346
Phone (760) 827-7200

2205 Vista Way
Oceanside, CA 92054-5661

4318 Mission Ave
Oceanside, CA 92057-6541
Phone (760) 901-5100

501 Washington St
San Diego, CA 92103-2239
Phone (619) 278-3300

9888 Genesee Ave
La Jolla, CA 92037-1205
Phone (858) 626-4123

9896 Genesee Ave
La Jolla, CA 92037-1205
Phone (858) 626-4123

9898 Genesee Ave
La Jolla, CA 92037-1205
Phone (858) 455-9100

Hospital & facility affiliations

  • Scripps Memorial Hospital - Encinitas Hospital, Encinitas, CA, CCN 050503
  • Scripps Green Hospital Hospital, La Jolla, CA, CCN 050424

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA21777CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Physician Assistant CurrentSince Aug 29, 2022 Accepting new patients
Scripps Health CurrentSince Aug 29, 2022 Accepting new patients
Scripps Health Past Accepting new patients

Locations

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

2205 Vista Way
Ste 310
Oceanside, CA 92054

130 Cedar Rd
Ste 210
Vista, CA 92083
Phone (760) 806-5500

Interoperability endpoints

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

Organizations & group practices 4

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": "1314662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392768000000",
    "number": "1225319676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2428 TEABERRY GLN",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920273580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29645 RANCHO CALIFORNIA RD",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925916200",
            "telephone_number": "951-695-7228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIEDEMA",
        "first_name": "JOY",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-30",
        "last_updated": "2014-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA21777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temecula, CA

Sources for this page

Verify at the official NPI Registry.