NPIMap

Organization Active NPI

San Diego Radiology Medical Group, Inc.

  • Specialist
  • Chula Vista, CA
National Provider Identifier
1386844439
Registry record updated Jul 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
SAN DIEGO RADIOLOGY MEDICAL GROUP, INC.
Practice address
860 Kuhn Dr
Suite 100
Chula Vista, CA 91914-4517
Phone
(619) 482-4592
Fax
(619) 482-1892
NPI assigned
Jul 18, 2007
Last updated
Jul 27, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2007

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

Authorized official

Name
Dr. Patrick H. Carey, MD
Title
President/Ceo
Phone
(858) 565-0950

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

860 Kuhn Dr
Suite 100
Chula Vista, CA 91914-4517

Mailing address

860 Kuhn Dr
Suite 100
Chula Vista, CA 91914-4517
Phone (619) 482-4592

Other identifiers 1

IdentifierTypeStateIssuer
GR0083815MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031112000793 CA Part B Supplier - Clinic/Group Practice 0143134353 Receives reassigned benefits from 72 practitioners
19 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: San Diego, CA; Solana Beach, CA; Chula Vista, CA; Coronado, CA; Del Mar, CA; Encinitas, CA; La Jolla, CA; Laguna Niguel, CA…

Other NPIs on the same Medicare enrollment 19

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 19

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1184716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185494400000",
    "number": "1386844439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 KUHN DR",
            "address_2": "SUITE 100",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919144517",
            "telephone_number": "619-482-4592",
            "fax_number": "619-482-1892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 KUHN DR",
            "address_2": "SUITE 100",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919144517",
            "telephone_number": "619-482-4592",
            "fax_number": "619-482-1892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN DIEGO RADIOLOGY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-18",
        "last_updated": "2007-07-27",
        "status": "A",
        "authorized_official_last_name": "CAREY",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "858-565-0950",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0083815",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.