Individual provider Active NPI

Robert Takao Coles, MD

  • Pediatrics Physician
  • Carlsbad, CA
National Provider Identifier
1407876691
Registry record updated May 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A53910 Issued in CA
Practice address
2176 Salk Ave Ste 200
Carlsbad, CA 92008-7346
Phone
(760) 827-7210
NPI assigned
Jul 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A53910 CA Primary

Addresses

Primary practice location

2176 Salk Ave Ste 200
Carlsbad, CA 92008-7346

Mailing address

10790 Rancho Bernardo Rd
San Diego, CA 92127-5705

Other identifiers 1

IdentifierTypeStateIssuer
658005MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050831000284 TX Practitioner - Pediatric Medicine 0648202556 Reassigns benefits to 1 organization
I20130628000498 CA Practitioner - Pediatric Medicine 0648202556 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince Jul 18, 2018 Accepting new patients
UC San Diego Health Community Group CurrentSince Jan 5, 2019 Accepting new patients
Scripps Health Current Accepting new patients
Acclaim Physician Group, Inc CurrentSince May 1, 2016 Accepting new patients
Scripps Health Pediatrics CurrentSince Jun 1, 2021 Accepting new patients
Scripps Health CurrentSince Jun 1, 2021 Accepting new patients
Regents of the University of California CurrentSince Jul 18, 2018 Accepting new patients
Scripps Health Current Accepting new patients
Cook Children'S Physician Network Pediatrics Past Accepting new patients
Regents of the University of California Past Accepting new patients
Dignity Health Past Accepting new patients
Scripps Health Past Accepting new patients
Tarrant County Hospital District Past Accepting new patients

Locations

2176 Salk Ave
Ste 200
Carlsbad, CA 92008
Phone (760) 827-7200

2176 Salk Ave
Carlsbad, CA 92008
Phone (760) 827-7200

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

File 54433
Los Angeles, CA 90074
Phone (858) 784-5645

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

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

10790 Rancho Bernardo Rd
San Diego, CA 92127
Phone (858) 554-2626

1350 S Main St
Fl 1
Fort Worth, TX 76104
Phone (817) 702-3701

1500 S Main St
Ft Worth, TX 76104
Phone (817) 921-3431

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621900800000",
    "number": "1407876691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10790 RANCHO BERNARDO RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2176 SALK AVE STE 200",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920087346",
            "telephone_number": "760-827-7210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLES",
        "first_name": "ROBERT",
        "middle_name": "TAKAO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A53910",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "658005",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlsbad, CA

Sources for this page

Verify at the official NPI Registry.