NPIMap

Organization Active NPI

Regents of the University of California

  • Diagnostic Radiology Physician
  • San Diego, CA
National Provider Identifier
1417050956
Registry record updated Apr 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
REGENTS OF THE UNIVERSITY OF CALIFORNIA
Practice address
200 W Arbor Dr
San Diego, CA 92103-9000
Phone
(800) 926-8273
Fax
(888) 539-8781
NPI assigned
Sep 7, 2006
Last updated
Apr 1, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2024

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

Authorized official

Name
Michael Dennis Price
Title
Director Revenue Cycle & Operations
Phone
(858) 249-6752

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging Physician 2085B0100X
Diagnostic Radiology Physician 2085R0202X Primary
Diagnostic Ultrasound Physician 2085U0001X

Addresses

Primary practice location

200 W Arbor Dr
San Diego, CA 92103-9000

Mailing address

PO Box 232410
San Diego, CA 92193-2410

Other identifiers 17

IdentifierTypeStateIssuer
364823301OtherUS DEPT OF LABOR
364823306OtherUS DEPT OF LABOR
GR0013571OtherCACALOPTIMA
72OtherCARYAN WHITE
364823302OtherUS DEPT OF LABOR
GR0013571MedicaidCA
364823300OtherUS DEPT OF LABOR
CQ4024OtherCARAILROAD MEDICARE
364823310OtherUS DEPT OF LABOR
364823304OtherUS DEPT OF LABOR
CGP016905OtherCAGHPP
ZZZ26235ZOtherCABLUE SHIELD GRP #
364823305OtherUS DEPT OF LABOR
13933OtherCACMS
364823303OtherUS DEPT OF LABOR
364823307OtherUS DEPT OF LABOR
364823308OtherUS DEPT OF LABOR

Other names 1

  • UCSD Medical Group Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040107000584 CA Part B Supplier - Clinic/Group Practice 3577476761 Receives reassigned benefits from 367 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: San Diego, CA; Sacramento, CA; San Jose, CA; San Luis Obispo, CA; Santa Rosa Valley, CA; South Pasadena, CA; Venice, CA; Concord, CA…

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Regents of the Ucsd9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

330 Lewis St
#8201
San Diego, CA 92103

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711929600000",
    "number": "1417050956",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000",
            "telephone_number": "800-926-8273",
            "fax_number": "888-539-8781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENTS OF THE UNIVERSITY OF CALIFORNIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-07",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A",
        "authorized_official_last_name": "PRICE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "DENNIS",
        "authorized_official_title_or_position": "DIRECTOR REVENUE CYCLE & OPERATIONS",
        "authorized_official_telephone_number": "858-249-6752"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "364823301",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "364823306",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALOPTIMA",
            "identifier": "GR0013571",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RYAN WHITE",
            "identifier": "72",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "364823302",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0013571",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "364823300",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CQ4024",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "364823310",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "364823304",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHPP",
            "identifier": "CGP016905",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD GRP #",
            "identifier": "ZZZ26235Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "364823305",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMS",
            "identifier": "13933",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "364823303",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "364823307",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "364823308",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UCSD Medical Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2024; 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.