Individual provider Active NPI

Joseph J Sheridan, M.D.

  • Child & Adolescent Psychiatry Physician
  • San Diego, CA
National Provider Identifier
1285773382
Registry record updated Oct 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
A97596 Issued in CA
Practice address
7850 Vista Hill Ave
San Diego, CA 92123-2717
Phone
(619) 630-1036
Fax
(619) 609-0059
NPI assigned
Feb 5, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A97596 CA
Child & Adolescent Psychiatry Physician 2084P0804X A97596 CA Primary

Addresses

Primary practice location

7850 Vista Hill Ave
San Diego, CA 92123-2717

Mailing address

PO Box 1770
La Mesa, CA 91944-1770
Phone (619) 464-1165

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
I20101105000419 CA Practitioner - Psychiatry 4880888668 Reassigns benefits to 2 organizations
Practice locations: San Diego, CA

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Medical College of Wisconsin, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

7850 Vista Hill Ave
San Diego, CA 92123-2717
Phone (619) 630-1036

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A97596CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Western Specialty Group L.P. Psychiatry Current Accepting new patients
Emergency and Acute Care Medical Corporation CurrentSince Sep 21, 2010 Accepting new patients
Joseph Sheridan MD Inc Psychiatry CurrentSince Nov 1, 2022 Accepting new patients

Locations

5555 Grossmont Center Dr
La Mesa, CA 91942
Phone (619) 465-0711

7850 Vista Hill Ave
San Diego, CA 92123
Phone (858) 836-8434

7901 Frost St
San Diego, CA 92123
Phone (619) 541-3400

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665100800000",
    "number": "1285773382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1770",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919441770",
            "telephone_number": "619-464-1165",
            "fax_number": "619-567-1011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7850 VISTA HILL AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921232717",
            "telephone_number": "619-630-1036",
            "fax_number": "619-609-0059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERIDAN",
        "first_name": "JOSEPH",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A97596",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "A97596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.