Individual provider Active NPI

Ali Youssef Fakhreddine, M.D.

  • Gastroenterology Physician
  • Encinitas, CA
National Provider Identifier
1336586908
Registry record updated Apr 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
A133244 Issued in CA
Practice address
310 Santa Fe Dr
Encinitas, CA 92024-5110
Phone
(760) 633-7280
Fax
(760) 633-7093
NPI assigned
May 22, 2013
Last updated
Apr 6, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X A133244 CA
Gastroenterology Physician 207RG0100X A133244 CA Primary

Addresses

Primary practice location

310 Santa Fe Dr
Encinitas, CA 92024-5110

Mailing address

10790 Rancho Bernardo Rd
San Diego, CA 92127-5705
Phone (760) 633-7280

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
I20170808003204 CA Practitioner - GastroenterologyPractitioner - Internal Medicine 0547531642 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Scripps HealthGroup PAC ID 9234033853, 1,450 clinicians

Practice addresses (Care Compare)

10666 N Torrey Pines Rd
La Jolla, CA 92037-1027
Phone (858) 554-9100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy90
Upper gastrointestinal (GI) endoscopy for acid reflux126

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A133244CAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Internal Medicine Current Accepting new patients
County of Los Angeles CurrentSince Jun 20, 2017 Accepting new patients
Scripps Health Current Accepting new patients
Scripps Health CurrentSince Aug 24, 2020 Accepting new patients
Scripps Health Current Accepting new patients
County of Los Angeles CurrentSince Jun 20, 2017 Accepting new patients
Scripps Health Internal Medicine CurrentSince Aug 24, 2020 Accepting new patients
Scripps Clinic Medical Group Past Accepting new patients
Scripps Health Past Accepting new patients

Locations

1000 S Fremont Ave
Unit 9
Alhambra, CA 91803

310 Santa Fe Dr
Encinitas, CA 92024
Phone (760) 633-7245

310 Santa Fe Dr
Ste 204
Encinitas, CA 92024
Phone (760) 633-7245

10666 N Torrey Pines Rd
La Jolla, CA 92037
Phone (858) 554-2626

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

File 54433
Los Angeles, CA 90074
Phone (858) 784-5645

10790 Rancho Bernardo Rd
San Diego, CA 92127
Phone (858) 554-2626

1000 W Carson St
Torrance, CA 90502
Phone (310) 222-3501

1000 W Carson St
#400
Torrance, CA 90502
Phone (310) 222-2401

Interoperability endpoints

  • Direct secure messaging: afakhreddine34921@scrippshlth.medalliesdirect.net

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1369180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1336586908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10790 RANCHO BERNARDO RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275705",
            "telephone_number": "760-633-7280",
            "fax_number": "760-633-7093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 SANTA FE DR",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920245110",
            "telephone_number": "760-633-7280",
            "fax_number": "760-633-7093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAKHREDDINE",
        "first_name": "ALI",
        "middle_name": "YOUSSEF",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-22",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A133244",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A133244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encinitas, CA

Sources for this page

Verify at the official NPI Registry.