Individual provider Active NPI

Elizabeth Trescot Macintyre, M.D.

  • Pediatrics Physician
  • Oceanside, CA
National Provider Identifier
1336520766
Registry record updated Jul 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A172352 Issued in CA
Practice address
3605 Vista Way Ste 130
Oceanside, CA 92056-4565
Phone
(760) 547-1010
Fax
(760) 547-1011
NPI assigned
Jun 11, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A172352 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

3605 Vista Way Ste 130
Oceanside, CA 92056-4565

Mailing address

3605 Vista Way Ste 130
Oceanside, CA 92056-4565
Phone (760) 547-1010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20191106002190 NC Practitioner - Pediatric Medicine 2769714054 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A172352CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Duke University Health System, Inc. CurrentSince Oct 20, 2018 Accepting new patients
Duke University Health System, Inc. CurrentSince Oct 20, 2018 Accepting new patients
Rady Children's Hospital San Diego Past Accepting new patients
Marilyn Kaufhold, M.D., a Medical Corporation Past Accepting new patients

Locations

5213 S Alston Ave
Durham, NC 27713
Phone (919) 620-4700

2301 Erwin Rd
Durham, NC 27705
Phone (919) 668-0289

3643 N Roxboro St
Durham, NC 27704
Phone (919) 470-6186

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": "1433980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625788800000",
    "number": "1336520766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3605 VISTA WAY STE 130",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920564565",
            "telephone_number": "760-547-1010",
            "fax_number": "760-547-1011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3605 VISTA WAY STE 130",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920564565",
            "telephone_number": "760-547-1010",
            "fax_number": "760-547-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACINTYRE",
        "first_name": "ELIZABETH",
        "middle_name": "TRESCOT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-11",
        "last_updated": "2021-07-09",
        "certification_date": "2021-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A172352",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, CA

Sources for this page

Verify at the official NPI Registry.