Pacific ENT Medical Group, Inc.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

G51656 Issued in CA

Legal business name

PACIFIC ENT MEDICAL GROUP, INC.

Practice address

6010 Hidden Valley Rd Ste 210
Carlsbad, CA 92011-4219

Phone

(858) 755-9343

Fax

(858) 792-1790

NPI assigned

Sep 22, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Cynthia R. Davis, M.D.

Title

President

Phone

(858) 755-9343

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14469/brand/1/csg/1/fhir/r4

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Hernan Goldsztein, MD

  • Otology & Neurotology Physician
  • Carlsbad, CA
  • NPI 1952426017

  Otolaryngology

  Medicare reassignment Care Compare group NPD
• Supriti Paul, MD

  • Otolaryngology Physician
  • Carlsbad, CA
  • NPI 1316063936
  Medicare reassignment Care Compare group NPD
• Moses David Salgado, M.D.

  • Otolaryngology Physician
  • Carlsbad, CA
  • NPI 1235345489
  Medicare reassignment Care Compare group NPD
• Blake B Wimmer, AUD

  • Audiologist
  • Carlsbad, CA
  • NPI 1164208955
  Medicare reassignment Care Compare group NPD
• Haley A Igoe

  • Physician Assistant
  • Fullerton, CA
  • NPI 1588347041
  Medicare reassignment Care Compare group
• Caitlyn Welsh

  • Audiologist
  • Carlsbad, CA
  • NPI 1962085779
  Care Compare group
• Cynthia G Davis, M.D.

  • Otolaryngology Physician
  • Solana Beach, CA
  • NPI 1275537193
  NPD

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614038400000",
    "number": "1336249135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6010 HIDDEN VALLEY RD STE 210",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920114219",
            "telephone_number": "858-755-9343",
            "fax_number": "858-792-1790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6010 HIDDEN VALLEY RD STE 210",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920114219",
            "telephone_number": "858-755-9343",
            "fax_number": "858-792-1790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC ENT MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "858-755-9343",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "G51656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Donald George Pack, D.C.
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• Packard Dental Group Inc.

• Otolaryngology Physician in Carlsbad, CA
• Providers in Carlsbad, CA by specialty
• Otolaryngology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.