Carla Stayboldt, M.D.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

G54618 Issued in CA

Practice address

7592 Metropolitan Dr
Suite 405-407
San Diego, CA 92108-4428

Phone

(619) 297-4900

Fax

(619) 297-5460

NPI assigned

Aug 3, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Pathology

Education

Oral Roberts University School of Medicine, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

San Diego Pathologists Medical Group IncGroup PAC ID 1254317423, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Scripps Mercy Hospital Hospital, San Diego, CA, CCN 050077

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: cstayboldt34925@scrippshlth.medalliesdirect.net

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.

• San Diego Pathologists Medical Group Inc

  • Anatomic Pathology & Clinical Pathology Physician
  • San Diego, CA
  • NPI 1982619466
  Medicare reassignment Care Compare group Authorized official
• Scripps Health

  dba Scripps Hospital Medical Services

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1487928891
  NPD
• Scripps Health

  • Clinical Medical Laboratory
  • La Jolla, CA
  • NPI 1427034990
  NPD (past)
• Scripps Health

  dba Scripps Memorial Hospital La Jolla

  • General Acute Care Hospital
  • La Jolla, CA
  • NPI 1841277704
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Scripps Health

  dba Scripps Mercy Hospital

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1659359446
  Care Compare affiliation

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213920000000",
    "number": "1427066836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7592 METROPOLITAN DR",
            "address_2": "SUITE 405",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084428",
            "telephone_number": "619-325-8726",
            "fax_number": "619-325-8728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7592 METROPOLITAN DR",
            "address_2": "SUITE 405-407",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084428",
            "telephone_number": "619-297-4900",
            "fax_number": "619-297-5460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAYBOLDT",
        "first_name": "CARLA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2008-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "G54618",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G546180",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alex Nicole Stautzenbach, LMFT
• Aaron David Stavinoha, M.D.
• Jennifer Z Stavish, RN, BSN
• Alison Kasayo Stawicki, D.D.S
• Maya Taisa Stawnychy
• Jonothan Carlos Stclair
• Michelle Stead
• Alexa Steady, RN
• Simone Stear Zwipf, LMFT, LPCC
• Lowell Stearn

• Anatomic Pathology & Clinical Pathology Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Anatomic Pathology & Clinical Pathology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.