Individual provider Active NPI

Maria Teresa Carriedo-Ceniceros, MD

  • Family Medicine Physician
  • National City, CA
National Provider Identifier
1295746618
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A78373 Issued in CA
Practice address
1136 D Avenue
National City, CA 91950
Phone
(619) 336-2300
Fax
(619) 336-2323
NPI assigned
Aug 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 A78373 CA Primary

Addresses

Primary practice location

1136 D Avenue
National City, CA 91950

Mailing address

4004 Beyer Blvd
San Ysidro, CA 92173-2007
Phone (619) 428-4463

Other identifiers 1

IdentifierTypeStateIssuer
FHC70267FOtherMEDI-CAL

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
I20040305001162 CA Practitioner - Family Practice 8022906676 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, San Diego School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centro de Salud de la Comunidad de San Ysidro,Inc.Group PAC ID 6901709435, 291 clinicians

Practice addresses (Care Compare)

3177 Ocean View Blvd
San Diego, CA 92113-1432
Phone (619) 662-4100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A78373CAMDFamily Medicine Physician

Practice roles (4 of 5)

OrganizationSpecialtyStatusNew 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 CurrentSince Sep 8, 2003 Accepting new patients
Centro de Salud de la Comunidad de San Ysidro, Inc. CurrentSince Sep 8, 2003 Accepting new patients
Centro de Salud de la Comunidad de San Ysidro, Inc. Past Accepting new patients

Locations

865 Third Ave
Ste 133
Chula Vista, CA 91911
Phone (619) 205-1360

1637 Third Ave
Ste B
Chula Vista, CA 91911
Phone (619) 425-1780

1136 D Ave
National City, CA 91950
Phone (619) 336-2300

950 S Euclid Ave
San Diego, CA 92114
Phone (619) 622-4100

316 25th St
San Diego, CA 92102
Phone (619) 234-1365

3177 Ocean View Blvd
San Diego, CA 92113
Phone (619) 231-9300

4690 El Cajon Blvd
San Diego, CA 92115
Phone (619) 478-5254

1601 Precision Park Ln
San Ysidro, CA 92173
Phone (619) 205-4585

4004 Beyer Blvd
San Ysidro, CA 92173
Phone (619) 428-1330

4050 Beyer Blvd
San Ysidro, CA 92173

120 Town Center Pkwy
Santee, CA 92071
Phone (619) 645-0111

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: mcarriedoceniceros18381@syhealth.direct-ci.com

Organizations & group practices 4

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": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295746618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4004 BEYER BLVD",
            "city": "SAN YSIDRO",
            "state": "CA",
            "postal_code": "921732007",
            "telephone_number": "619-428-4463",
            "fax_number": "619-428-2625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1136 D AVENUE",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "91950",
            "telephone_number": "619-336-2300",
            "fax_number": "619-336-2323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRIEDO-CENICEROS",
        "first_name": "MARIA",
        "middle_name": "TERESA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A78373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "FHC70267F",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in National City, CA

Sources for this page

Verify at the official NPI Registry.