NPIMap

Individual provider Active NPI

Stefan Moldovan, M.D.

  • Surgery Physician
  • Escondido, CA
National Provider Identifier
1245291624
Registry record updated Jun 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A56200 Issued in CA
Practice address
625 W Citracado Pkwy
Suite 203
Escondido, CA 92025-6428
Phone
(760) 739-7666
Fax
(760) 739-7633
NPI assigned
Mar 28, 2006
Last updated
Jun 18, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A56200 CA Primary

Addresses

Primary practice location

625 W Citracado Pkwy
Suite 203
Escondido, CA 92025-6428

Mailing address

PO Box 462079
Escondido, CA 92046-2079
Phone (760) 739-7666

Other identifiers 1

IdentifierTypeStateIssuer
00A562000MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040302001402 CA Practitioner - General Surgery 3577450600 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sasha Salloum MD Inc a Professional Medical CorporationGroup PAC ID 5991012130, 8 clinicians

Practice addresses (Care Compare)

1111 Broadway
Suite 305
Chula Vista, CA 91911-2700
Phone (619) 567-7007

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40
Cost
78.64

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Varicose vein removal139
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
40079TXMDPsychologist
A56200CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sasha Salloum MD Inc a Professional Medical Corporation Surgery CurrentSince Sep 27, 2020 Accepting new patients
Graybill Medical Group Inc Surgery CurrentSince Nov 20, 2017 Accepting new patients
Vascular Associates of San Diego Past Accepting new patients
Sharp Memorial Hospital Past Accepting new patients
Valley Radiology Consultants Medical Group, Inc Surgery PastSince May 11, 2025 Accepting new patients
Baylor College of Medicine Surgery Past Accepting new patients
Scripps Health Past Accepting new patients
Palomar Health Past Accepting new patients
Grossmont Medical Clinic a Professional Corporation Past Accepting new patients
The Methodist Hospital Past Accepting new patients
Arch Health Partners, Inc Neurological Surgery Past Accepting new patients
North County Vascular Center a Ca Professional Medical Corporation Past Accepting new patients

Locations

1111 Broadway
Ste 305
Chula Vista, CA 91911
Phone (619) 425-8212

1045 E Pennsylvania Ave
Escondido, CA 92025
Phone (760) 741-5466

2185 Citracado Pkwy
Escondido, CA 92029
Phone (442) 281-5000

225 E 2nd Ave
Escondido, CA 92025

332 S Juniper St
Ste 100
Escondido, CA 92025
Phone (760) 291-6650

2433 Marshall Ave
Ste 1
Imperial, CA 92251
Phone (760) 406-4402

6719 Alvarado Rd
Ste 303
San Diego, CA 92120
Phone (619) 286-9311

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 12

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 3

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": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276819200000",
    "number": "1245291624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 462079",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920462079",
            "telephone_number": "760-739-7666",
            "fax_number": "760-739-7633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 W CITRACADO PKWY",
            "address_2": "SUITE 203",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920256428",
            "telephone_number": "760-739-7666",
            "fax_number": "760-739-7633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLDOVAN",
        "first_name": "STEFAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2010-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A56200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A562000",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Escondido, CA

Sources for this page

Verify at the official NPI Registry.