Active NPI
David Peter Neison, MD
- Emergency Medicine Physician
- La Mesa, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 2008-01834
- Practice address
- 5555 Grossmont Center Dr
La Mesa, CA 91942-3019 - Phone
- (619) 740-4405
- NPI assigned
- Dec 6, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | A112078 | CA | |
| Emergency Medicine Physician | 207P00000X | 2008-01834 | NC | Primary |
Addresses
Primary practice location
5555 Grossmont Center Dr
La Mesa, CA 91942-3019
Mailing address
5555 Grossmont Center Dr
La Mesa, CA 91942-3019
Phone (619) 740-4405
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5910725 | Medicaid | NC |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
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
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cep America - California | Emergency Medicine | Current | Accepting new patients |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Cep America-California | Emergency Medicine | Current | Accepting new patients |
| Cep America - California | Emergency Medicine | Current | Accepting new patients |
| Wake Forest University Health Sciences | Past | Accepting new patients | |
| Grossmont Emergency Medical Group | Emergency Medicine | Past | Accepting new patients |
Locations
6501 Coyle Ave
Carmichael, CA 95608
Phone (916) 537-5000
751 Medical Center Ct
Chula Vista, CA 91911
Phone (619) 482-3639
1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423
4001 J St
Sacramento, CA 95819
Phone (916) 453-4037
7500 Hospital Dr
Sacramento, CA 95823
Phone (916) 423-3000
4647 Zion Ave
San Diego, CA 92120
Phone (619) 528-3038
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.
-
- Health Maintenance Organization
- Baldwin Park, CA
- NPI 1770515280
-
- Emergency Medicine Physician
- Murrieta, CA
- NPI 1588552848
-
- Emergency Medicine Physician
- La Mesa, CA
- NPI 1861437501
-
- Multi-Specialty Clinic/Center
- Winston Salem, NC
- NPI 1003803032
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196899200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638921600000",
"number": "1316120918",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5555 GROSSMONT CENTER DR",
"city": "LA MESA",
"state": "CA",
"postal_code": "919423019",
"telephone_number": "619-740-4405"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5555 GROSSMONT CENTER DR",
"city": "LA MESA",
"state": "CA",
"postal_code": "919423019",
"telephone_number": "619-740-4405"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEISON",
"first_name": "DAVID",
"middle_name": "PETER",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-12-06",
"last_updated": "2021-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "CA",
"license": "A112078",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "NC",
"license": "2008-01834",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5910725",
"state": "NC"
}
],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Southern California Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "4647 Zion Ave",
"city": "San Diego",
"state": "CA",
"country_code": "US",
"postal_code": "921202507",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in La Mesa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.