Ketevan Jorjadze, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95017739 Issued in CA

Practice address

3636 Fifth Ave Ste 300
San Diego, CA 92103-4230

Phone

(619) 814-5500

NPI assigned

Jan 10, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Onclick Healthcare IncorporatedGroup PAC ID 9830511260, 63 clinicians

Monica Perlman MD IncGroup PAC ID 8820035884, 357 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

92.17 of 100Reported as group

Quality

100

Promoting interoperability

100

Improvement activities

40

Cost

73.9

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Monica Perlman MD Inc.

  • Primary Care Clinic/Center
  • La Jolla, CA
  • NPI 1134309305
  Medicare reassignment Care Compare group NPD
• Onclick Healthcare Incorporated

  • Health Service Clinic/Center
  • Westlake Village, CA
  • NPI 1467074963
  Medicare reassignment Care Compare group NPD
• Regents of the University of California

  • Pharmacy
  • San Diego, CA
  • NPI 1598786576
  NPD (past)
• UC San Diego Health - Rancho Family Medical Group

  • Multi-Specialty Clinic/Center
  • Temecula, CA
  • NPI 1003385071
  NPD (past)

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

{
    "created_epoch": "1610236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658966400000",
    "number": "1336737840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3636 5TH AVE",
            "address_2": "STE 300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921034230",
            "telephone_number": "619-814-5500",
            "fax_number": "619-794-0260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3636 FIFTH AVE STE 300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921034230",
            "telephone_number": "619-814-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORJADZE",
        "first_name": "KETEVAN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-10",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F346697",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95017739",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS",
            "identifier": "F346697",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maren Jorgensen
• Monica Rae Jorgensen, ACSW, BCBA
• Thomas Cleon Jorgensen, DEEP SEA DIVING IDC
• Christa Jorgenson, MS, RD
• Chanel Jorgeson
• Arianne Nicole Jornales
• Jose & Karla Ruiz, Olga & Ramon Cardona Partnership
• Jose C. Castillo, D.D.S., Inc.
• Jose E Otero MD Inc
• Jose L. Lopez, DDS, Inc

• Family Nurse Practitioner in San Diego, CA
• Providers in San Diego, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2022; 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.
• 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.