NPIMap

Individual provider Active NPI

Mushrik Kaisey, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Chula Vista, CA
National Provider Identifier
1386654010
Registry record updated Jun 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
A72963 Issued in CA
Practice address
340 4TH Ave
#9
Chula Vista, CA 91910-3813
Phone
(619) 426-9731
Fax
(619) 427-9733
NPI assigned
Aug 8, 2006
Last updated
Jun 15, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X A72963 CA Primary

Addresses

Primary practice location

340 4TH Ave
#9
Chula Vista, CA 91910-3813

Mailing address

340 4TH Ave
#9
Chula Vista, CA 91910-3813
Phone (619) 426-9731

Other identifiers 1

IdentifierTypeStateIssuer
00A729631MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040129000382 CA Practitioner - Internal MedicinePractitioner - Hospice/Palliative CarePractitioner - Geriatric Medicine 9830092618 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine, Hospice/Palliative Care
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rancho Family Medical Group IncGroup PAC ID 6305741240, 112 clinicians

Practice addresses (Care Compare)

340 4TH Ave
Suite 9
Chula Vista, CA 91910-3813
Phone (619) 426-9731

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
72963CAMDPharmacist
A72963CAMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Current Accepting new patients
Rancho Family Medical Group, Inc. CurrentSince Oct 21, 2024 Accepting new patients
South Bay Geriatric and Internal Medicine Inc CurrentSince Jan 6, 2011 Accepting new patients
UC San Diego Health - Rancho Family Medical Group Past Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
Scripps Health Past Accepting new patients
Emergency and Acute Care Medical Corporation PastSince Jan 14, 2024 Accepting new patients
Grossmont Hospital Corporation Past Accepting new patients
Sharp Chula Vista Medical Center Past Accepting new patients
Scripps Health Past Accepting new patients

Locations

263 Church Ave
Chula Vista, CA 91910
Phone (619) 422-1324

340 Fourth Ave
Ste 9
Chula Vista, CA 91910
Phone (619) 202-4994

28780 Single Oak Dr
Ste 160
Temecula, CA 92590
Phone (951) 658-9461

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JJFCBA
  • FHIR API: https://fhir4.healow.com/fhir/r4/JJFCBA/Endpoint/JJFCBA
  • Direct secure messaging: mkaisey81169@scrippshlth.medalliesdirect.net

Organizations & group practices 10

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 6

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": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308096000000",
    "number": "1386654010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 4TH AVE",
            "address_2": "#9",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919103813",
            "telephone_number": "619-426-9731",
            "fax_number": "619-427-9733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 4TH AVE",
            "address_2": "#9",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919103813",
            "telephone_number": "619-426-9731",
            "fax_number": "619-427-9733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAISEY",
        "first_name": "MUSHRIK",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2011-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "CA",
            "license": "A72963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A729631",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

Verify at the official NPI Registry.