Individual provider Active NPI

Taylor Martin Deal, M.D.

  • Anatomic Pathology Physician
  • San Diego, CA
National Provider Identifier
1386962132
Registry record updated May 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology PhysicianTaxonomy code 207ZP0101X
License
A128164 Issued in CA
Practice address
300 Fir St
San Diego, CA 92101-2327
Phone
(619) 446-1971
Fax
(619) 446-1509
NPI assigned
May 4, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology Physician 207ZP0101X A128164 CA Primary

Addresses

Primary practice location

300 Fir St
San Diego, CA 92101-2327

Mailing address

300 Fir St
San Diego, CA 92101-2327
Phone (619) 446-1971

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
I20180621002597 CA Practitioner - Pathology 6901042654 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A128164CAMDAnatomic Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince May 7, 2018 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince May 7, 2018 Accepting new patients
Sharp Rees-Stealy Medical Center Past Accepting new patients
Sharp Memorial Hospital Past Accepting new patients

Locations

300 Fir St
San Diego, CA 92101
Phone (619) 446-1586

2929 Health Center Dr
San Diego, CA 92123
Phone (858) 939-6531

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

Interoperability endpoints

  • Direct secure messaging: tdeal33586@sharphealthcare.direct-ci.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1272931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493942400000",
    "number": "1386962132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 FIR ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921012327",
            "telephone_number": "619-446-1971",
            "fax_number": "619-446-1509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 FIR ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921012327",
            "telephone_number": "619-446-1971",
            "fax_number": "619-446-1509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAL",
        "first_name": "TAYLOR",
        "middle_name": "MARTIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-04",
        "last_updated": "2017-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "CA",
            "license": "A128164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.