Active NPI
Nour Moataz Elgezawi, ACSW
- Clinical Social Worker
- El Cajon, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 109173
- Practice address
- 875 El Cajon Blvd
El Cajon, CA 92020-5714 - Phone
- (619) 662-4100
- NPI assigned
- Jul 26, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 109173 | ||
| Clinical Social Worker | 1041C0700X | |||
| Clinical Social Worker | 1041C0700X | 109173 | CA | Primary |
Addresses
Primary practice location
875 El Cajon Blvd
El Cajon, CA 92020-5714
Mailing address
1601 Precision Park LN
San Diego, CA 92173-1345
Phone (619) 662-4100
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | EHR | Health Information Exchange (HIE) |
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
875 El Cajon Blvd
El Cajon, CA 92020-5714
Phone (619) 662-4100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Centro de Salud de la Comunidad de San Ysidro, Inc. | Current | Accepting new patients | |
| Centro de Salud de la Comunidad de San Ysidro, Inc. | Current | Accepting new patients | |
| Centro de Salud de la Comunidad de San Ysidro Inc | Current | Accepting new patients |
Locations
1637 Third Ave
Ste B
Chula Vista, CA 91911
Phone (619) 425-1780
875 El Cajon Blvd
El Cajon, CA 92020
Phone (619) 205-4585
1136 D Ave
National City, CA 91950
Phone (619) 336-2300
1601 Precision Park Ln
San Ysidro, CA 92173
Phone (619) 205-4585
Organizations & group practices 3
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.
-
dba San Ysidro Health Precision Park
- Federally Qualified Health Center (FQHC)
- San Diego, CA
- NPI 1124782685
-
dba San Ysidro Health Senior Dental Center
- Federally Qualified Health Center (FQHC)
- San Diego, CA
- NPI 1457033813
-
dba San Ysidro Health King-Chavez Health Center
- Federally Qualified Health Center (FQHC)
- San Diego, CA
- NPI 1538262092
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1658793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744934400000",
"number": "1255067880",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1601 PRECISION PARK LN",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921731345",
"telephone_number": "619-662-4100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "875 EL CAJON BLVD",
"city": "EL CAJON",
"state": "CA",
"postal_code": "920205714",
"telephone_number": "619-662-4100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELGEZAWI",
"first_name": "NOUR",
"middle_name": "MOATAZ",
"credential": "ACSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-26",
"last_updated": "2025-04-18",
"certification_date": "2025-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": "109173",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "109173",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "EHR",
"affiliation": "N",
"endpointDescription": "HIS",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"useOtherDescription": "billing",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "875 El Cajon Blvd",
"city": "El Cajon",
"state": "CA",
"country_code": "US",
"postal_code": "920205714",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in El Cajon, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2025; 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.