Individual provider Active NPI

Anna Kathryn Van Niekerk, DO

  • Family Medicine Physician
  • San Diego, CA
National Provider Identifier
1265820112
Registry record updated Apr 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A15206 Issued in CA
Practice address
4510 Executive Dr Ste 215
San Diego, CA 92121-3023
Phone
(800) 926-8273
Fax
(888) 539-8781
NPI assigned
Dec 30, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A15206 CA Primary

Addresses

Primary practice location

4510 Executive Dr Ste 215
San Diego, CA 92121-3023

Mailing address

File 57326
Los Angeles, CA 90074-7326

Other practice location 1

203 W F St
San Diego, CA 92101-6016
Phone (800) 926-8273

Other practice location 2

2131 3rd Ave Ste 100
San Diego, CA 92101-2084
Phone (800) 926-8273

Other practice location 3

910 Sycamore Ave Ste 270
Vista, CA 92081-7852
Phone (800) 926-8273

Other practice location 4

16950 Via Tazon
San Diego, CA 92127-1607
Phone (800) 926-8273

Other practice location 5

6030 Village Way Ste 200
San Diego, CA 92130-2973
Phone (800) 926-8273

Other practice location 6

1505 Encinitas Blvd
Encinitas, CA 92024-2933
Phone (800) 926-8273

Other practice location 7

2295 Otay Lakes Rd Ste 110
Chula Vista, CA 91915-1160
Phone (800) 926-8273

Other names 1

  • Anna K. Kubli Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180921002816 CA Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 9638420136 Reassigns benefits to 2 organizations
I20230731000249 FL Practitioner - Family Practice 9638420136 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Osteopathic Manipulative Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
UC San Diego Health Community GroupGroup PAC ID 3971849175, 109 clinicians
Mayo Clinic JacksonvilleGroup PAC ID 5698689297, 1,595 clinicians

Practice addresses (Care Compare)

16950 Via Tazon
San Diego, CA 92127-1607
Phone (800) 926-8273

4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone (904) 953-2000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A15206CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Jacksonville Current Accepting new patients
Mayo Clinic Jacksonville CurrentSince Jul 19, 2023 Accepting new patients
UC San Diego Health Community Group CurrentSince Jan 8, 2019 Accepting new patients
Regents of the University of California Family Medicine CurrentSince Jul 15, 2018 Accepting new patients
Regents of the University of California CurrentSince Jul 15, 2018 Accepting new patients
Mayo Clinic Jacksonville CurrentSince Jul 19, 2023 Accepting new patients

Locations

2295 Otay Lakes Rd
Ste 110
Chula Vista, CA 91915
Phone (619) 502-7854

1505 Encinitas Blvd
Encinitas, CA 92024

File 57326
Los Angeles, CA 90074

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

4510 Executive Dr
Ste 215
San Diego, CA 92121
Phone (858) 657-6624

16950 Via Tazon
San Diego, CA 92127
Phone (858) 521-2265

203 W F St
San Diego, CA 92101
Phone (619) 471-3800

6030 Village Way
Ste 200
San Diego, CA 92130

2131 3rd Ave
Ste 100
San Diego, CA 92101

910 Sycamore Ave
Ste 270
Vista, CA 92081
Phone (619) 598-1776

4500 San Pablo Rd S
Jacksonville, FL 32224
Phone (904) 721-4815

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

Interoperability endpoints

  • Direct secure messaging: anna.van.niekerk.1@21075.direct.athenahealth.com
  • Direct secure messaging: avanniekerk1997976@ehrdirect.mayoclinicmsg.org
  • Direct secure messaging: avanniekerk579476@direct.ochin.org

Organizations & group practices 6

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 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": "1419897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775088000000",
    "number": "1265820112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FILE 57326",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900747326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4510 EXECUTIVE DR STE 215",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921213023",
            "telephone_number": "800-926-8273",
            "fax_number": "888-539-8781"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "203 W F St",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921016016",
            "country_code": "US",
            "telephone_number": "800-926-8273",
            "fax_number": "888-539-8781",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2131 3rd Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921012084",
            "country_code": "US",
            "telephone_number": "800-926-8273",
            "fax_number": "888-539-8781",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "910 Sycamore Ave Ste 270",
            "address_purpose": "LOCATION",
            "city": "Vista",
            "state": "CA",
            "postal_code": "920817852",
            "country_code": "US",
            "telephone_number": "800-926-8273",
            "fax_number": "888-539-8781",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16950 Via Tazon",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921271607",
            "country_code": "US",
            "telephone_number": "800-926-8273",
            "fax_number": "888-539-8781",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6030 Village Way Ste 200",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921302973",
            "country_code": "US",
            "telephone_number": "800-926-8273",
            "fax_number": "888-539-8781",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1505 Encinitas Blvd",
            "address_purpose": "LOCATION",
            "city": "Encinitas",
            "state": "CA",
            "postal_code": "920242933",
            "country_code": "US",
            "telephone_number": "800-926-8273",
            "fax_number": "888-539-8781",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2295 Otay Lakes Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Chula Vista",
            "state": "CA",
            "postal_code": "919151160",
            "country_code": "US",
            "telephone_number": "800-926-8273",
            "fax_number": "888-539-8781",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN NIEKERK",
        "first_name": "ANNA",
        "middle_name": "KATHRYN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-30",
        "last_updated": "2026-04-02",
        "certification_date": "2026-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A15206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNA",
            "last_name": "KUBLI",
            "middle_name": "K.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.