NPIMap

Individual provider Active NPI

Phillip Dickinson, M.D.

  • Family Medicine Physician
  • La Mesa, CA
National Provider Identifier
1386737773
Registry record updated Aug 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A86720 Issued in CA
Practice address
8554 La Mesa Blvd
La Mesa, CA 91941
Phone
(619) 464-4469
Fax
(619) 639-0300
NPI assigned
Sep 30, 2006
Last updated
Aug 3, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A86720 CA
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X A86720 CA Primary

Addresses

Primary practice location

8554 La Mesa Blvd
La Mesa, CA 91941

Mailing address

PO Box 2213
La Mesa, CA 91943-2213

Other practice location 1

420 Heffernan Ave Ste D
Calexico, CA 92231-4718
Phone (760) 270-9126

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
I20040622001690 CA Practitioner - General Surgery 0345225454 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Howard University College of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency and Acute Care Medical CorporationGroup PAC ID 9537108279, 431 clinicians

Practice addresses (Care Compare)

5555 Grossmont Ctr Dr
La Mesa, CA 91942-3019
Phone (619) 740-6000

8554 La Mesa Blvd
La Mesa, CA 91942-9558
Phone (619) 464-4469

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A86720CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vitali Aizin, M.D. Inc. Multi-Specialty Current Accepting new patients
Scripps Health Multi-Specialty Current Accepting new patients
Grossmont Hospital Corporation Multi-Specialty Past Accepting new patients
Upper West Side Medical P.L.L.C. Multi-Specialty PastSince Oct 1, 2015 Accepting new patients
Sharp Coronado Hospital and Healthcare Center Past Accepting new patients
Scripps Health Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: pdickinson80417@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 1

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": "1159574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533254400000",
    "number": "1386737773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2213",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919432213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8554 LA MESA BLVD",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "91941",
            "telephone_number": "619-464-4469",
            "fax_number": "619-639-0300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "420 Heffernan Ave Ste D",
            "address_purpose": "LOCATION",
            "city": "Calexico",
            "state": "CA",
            "postal_code": "922314718",
            "country_code": "US",
            "telephone_number": "760-270-9126",
            "fax_number": "760-890-0005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DICKINSON",
        "first_name": "PHILLIP",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-30",
        "last_updated": "2018-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A86720",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A86720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mesa, CA

Sources for this page

Verify at the official NPI Registry.