Individual provider Active NPI

Jennifer Marie Dan, M.D., PH.D.

  • Infectious Disease Physician
  • La Jolla, CA
National Provider Identifier
1225343601
Registry record updated Apr 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
119193 Issued in CA
Practice address
9500 Gilman Dr # 711
Stein Research Building, Division of Infectious Disease
La Jolla, CA 92093-0711
Phone
(858) 822-0333
Fax
(858) 822-5362
NPI assigned
Aug 10, 2010
Last updated
Apr 1, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 119193 CA
Infectious Disease Physician 207RI0200X 119193 CA Primary

Addresses

Primary practice location

9500 Gilman Dr # 711
Stein Research Building, Division of Infectious Disease
La Jolla, CA 92093-0711

Mailing address

9500 Gilman Dr # 711
Stein Research Building, Division of Infectious Disease
La Jolla, CA 92093-0711
Phone (858) 822-0333

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
I20161021001789 CA Practitioner - Infectious Disease 5294029682 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Boston University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

200 W Arbor Dr
San Diego, CA 92103-3109
Phone (858) 657-7000

Hospital & facility affiliations

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
119193CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California Current Accepting new patients
Regents of the University of California Internal Medicine CurrentSince Dec 1, 2016 Accepting new patients
Regents of the University of California CurrentSince Dec 1, 2016 Accepting new patients
Regents of the University of California Past Accepting new patients
Regents of the University of California Ucsd Head and Neck Surgery Past Accepting new patients

Locations

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5720

4168 Front St
Fl 3
San Diego, CA 92103
Phone (619) 543-3995

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1281398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554076800000",
    "number": "1225343601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 GILMAN DR # 711",
            "address_2": "STEIN RESEARCH BUILDING, DIVISION OF INFECTIOUS DISEASE",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920930711",
            "telephone_number": "858-822-0333",
            "fax_number": "858-822-5362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 GILMAN DR # 711",
            "address_2": "STEIN RESEARCH BUILDING, DIVISION OF INFECTIOUS DISEASE",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920930711",
            "telephone_number": "858-822-0333",
            "fax_number": "858-822-5362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAN",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-10",
        "last_updated": "2019-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "119193",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "CA",
            "license": "119193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

Verify at the official NPI Registry.