Individual provider Active NPI

Chevon Alderson, MD

  • Family Medicine Physician
  • San Diego, CA
National Provider Identifier
1396124145
Registry record updated Apr 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A155746 Issued in CA
Practice address
2630 1St Ave
San Diego, CA 92103-6599
Phone
(619) 234-2158
Fax
(619) 234-0206
NPI assigned
May 27, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A155746 CA Primary

Addresses

Primary practice location

2630 1St Ave
San Diego, CA 92103-6599

Mailing address

1171 Camino Levante
Chula Vista, CA 91913-3453
Phone (310) 622-2802

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
I20181022003422 CA Practitioner - Family Practice 4385959055 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Pennsylvania State University College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
San Diego American Indian Health CenterGroup PAC ID 9830096411, 2 clinicians

Practice addresses (Care Compare)

2630 1St Ave
San Diego, CA 92103-6599
Phone (619) 234-2158

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A155746CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
San Diego American Indian Health Center CurrentSince Jan 6, 2025 Accepting new patients

Locations

2630 1st Ave
Ste 204
San Diego, CA 92103

2630 1st Ave
San Diego, CA 92103
Phone (619) 234-2158

2630 1st Ave
Ste 209
San Diego, CA 92103

2630 1st Ave
Ste 211
San Diego, CA 92103

2602 1st Ave
Ste 105
San Diego, CA 92103

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IFGCCD

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1432684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743638400000",
    "number": "1396124145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1171 CAMINO LEVANTE",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919133453",
            "telephone_number": "310-622-2802",
            "fax_number": "844-404-8924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2630 1ST AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921036599",
            "telephone_number": "619-234-2158",
            "fax_number": "619-234-0206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALDERSON",
        "first_name": "CHEVON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-27",
        "last_updated": "2025-04-03",
        "certification_date": "2025-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A155746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.