Individual provider Active NPI

Benjamin Liotta, MD

  • Emergency Medicine Physician
  • San Diego, CA
National Provider Identifier
1396270278
Registry record updated Jul 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
158160 Issued in CA
Practice address
200 W Arbor Dr
Mc8676
San Diego, CA 92103-9000
Phone
(619) 543-4627
Fax
(619) 543-3115
NPI assigned
Apr 27, 2017
Last updated
Jul 14, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 158160 CA Primary

Addresses

Primary practice location

200 W Arbor Dr
Mc8676
San Diego, CA 92103-9000

Mailing address

PO Box 232410
San Diego, CA 92193-2410
Phone (619) 543-4627

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
I20200716003120 CA Practitioner - Emergency Medicine 0941624464 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

200 W Arbor Dr
San Diego, CA 92103-9000
Phone (858) 657-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.77 of 100Reported as group
Quality
84.13
Promoting interoperability
100
Improvement activities
40
Cost
73.88

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
158160CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Palomar Emergency Physicians, Inc Emergency Medicine CurrentSince Aug 1, 2021 Accepting new patients
Cep America - California Emergency Medicine CurrentSince Jun 1, 2020 Accepting new patients
Cep America - California Emergency Medicine Current Accepting new patients
Regents of the University of California CurrentSince Jun 14, 2021 Accepting new patients
Regents of the University of California Emergency Medicine CurrentSince Jun 14, 2021 Accepting new patients
Cep America-California Emergency Medicine CurrentSince Jun 1, 2020 Accepting new patients
Encinitas Emergency Medicine, Inc. Emergency Medicine CurrentSince Feb 28, 2021 Accepting new patients
UC San Diego Health Community Group CurrentSince Jun 14, 2021 Accepting new patients
Regents of the University of California Emergency Medicine CurrentSince Jul 1, 2021 Accepting new patients
Scripps Health Past Accepting new patients
Regents of the University of California Past Accepting new patients
Regents of the University of California Ucsd Head and Neck Surgery Past Accepting new patients

Locations

751 Medical Center Ct
Chula Vista, CA 91911
Phone (619) 482-3639

1415 Ross Ave
El Centro, CA 92243
Phone (760) 339-4045

354 Santa Fe Dr
Encinitas, CA 92024
Phone (760) 230-2251

8910 Villa La Jolla Dr
Ste 100
La Jolla, CA 92037

9300 Campus Point Dr
La Jolla, CA 92037
Phone (619) 957-7000

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

15615 Pomerado Rd
Poway, CA 92064
Phone (858) 613-4000

16950 Via Tazon
San Diego, CA 92127
Phone (858) 521-2265

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

200 W Arbor Dr
#8676
San Diego, CA 92103
Phone (619) 543-6213

6655 Alvarado Rd
San Diego, CA 92120
Phone (619) 229-3130

Organizations & group practices 12

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": "1493251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626220800000",
    "number": "1396270278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 232410",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921932410",
            "telephone_number": "619-543-4627",
            "fax_number": "619-543-3115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "address_2": "MC8676",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000",
            "telephone_number": "619-543-4627",
            "fax_number": "619-543-3115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIOTTA",
        "first_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-27",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "158160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.