Medicus MD Inc

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

A48505 Issued in CA

Legal business name

MEDICUS MD INC

Practice address

3969 4TH Ave
Ste #203
San Diego, CA 92103-3165

Phone

(619) 294-6500

Fax

(619) 294-6505

NPI assigned

Jul 18, 2006

Organization subpart

No

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

Authorized official

Name

Barbara Denysiak, MDNPI 1003085572

Title

Vice President

Phone

(619) 294-6500

Specialties & licenses 1

Addresses

Other names 1

• MEDICUS MD INC A DELAWARE CORPORATION Former legal business name

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Other NPIs on the same Medicare enrollment 1

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

• Barbara Denysiak, M.D.

  • Legal Medicine
  • San Diego, CA
  • NPI 1003085572

  I20060824000285

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

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.

• Jacqueline Joanna Denysiak, M.D.

  • Family Medicine Physician
  • San Diego, CA
  • NPI 1902337827
  Medicare reassignment Care Compare group NPD
• Barbara Denysiak, M.D.

  • Legal Medicine
  • San Diego, CA
  • NPI 1003085572
  Care Compare group NPD Authorized official
• Brian Lantos, DO

  • Family Medicine Physician
  • Corvallis, OR
  • NPI 1184094849

  CA

  Medicare reassignment NPD
• Katherine Wainright Hall, DNP, APRN, FBP-BC

  • Family Medicine Physician
  • San Diego, CA
  • NPI 1679492508
  NPD

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694131200000",
    "number": "1427076009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3969 4TH AVE",
            "address_2": "STE #203",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921033165",
            "telephone_number": "619-294-6500",
            "fax_number": "619-294-6505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3969 4TH AVE",
            "address_2": "STE #203",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921033165",
            "telephone_number": "619-294-6500",
            "fax_number": "619-294-6505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICUS MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-18",
        "last_updated": "2023-09-08",
        "certification_date": "2023-09-08",
        "status": "A",
        "authorized_official_last_name": "DENYSIAK",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "619-294-6500",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "A48505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDICUS MD INC A DELAWARE CORPORATION",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Primary Care Clinic/Center in San Diego, CA
• Providers in San Diego, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.