NPIMap

Individual provider Active NPI

Tina Marie Mitterling, PA-C

  • Physician Assistant
  • San Diego, CA
National Provider Identifier
1427242239
Registry record updated Oct 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
67090 Issued in CA
Practice address
3705 Mission Blvd
San Diego, CA 92109-7104
Phone
(619) 515-2444
NPI assigned
Sep 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 67090 CA Primary
Medical Physician Assistant 363AM0700X 1235 SC

Addresses

Primary practice location

3705 Mission Blvd
San Diego, CA 92109-7104

Mailing address

823 Gateway Center Way
San Diego, CA 92102-4541
Phone (619) 515-2300

Other identifiers 3

IdentifierTypeStateIssuer
0595PAMedicaidSC
3025372MedicaidOH
0077981MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, OH, CA3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20071220000710 SC Practitioner - Physician Assistant 1355431768
I20090421000119 OH Practitioner - Physician Assistant 1355431768 Reassigns benefits to 3 organizations
I20251020000930 CA Practitioner - Physician Assistant 1355431768 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1809 National Ave
San Diego, CA 92113-2113
Phone (619) 515-2300

3705 Mission Blvd
San Diego, CA 92109-7104
Phone (619) 515-2444

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1235SCMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health-Allen Hospital LLC CurrentSince Sep 17, 2012 Accepting new patients
Family Health Centers of San Diego, Inc Current Accepting new patients
Mercy Health Physicians Lorain Specialty Care LLC Physician Assistant CurrentSince Jan 1, 2022 Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Oct 13, 2025 Accepting new patients
Mercy Health Physicians Lorain Specialty Care LLC CurrentSince Jan 1, 2022 Accepting new patients
Family Health Centers of San Diego, Inc. CurrentSince Oct 13, 2025 Accepting new patients
Mercy Health Physicians Lorain, LLC Physician Assistant CurrentSince Oct 1, 2013 Accepting new patients
Mary Black Physician Services LLC Physician Assistant Past Accepting new patients

Locations

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

578 N Leavitt Rd
Amherst, OH 44001
Phone (440) 960-3912

105 Opportunity Way
Lagrange, OH 44050
Phone (440) 222-4160

600 Kendal Dr
Oberlin, OH 44074
Phone (440) 775-0094

840 Patriot Dr
Wellington, OH 44090
Phone (440) 647-2225

508 Dickson St
Wellington, OH 44090
Phone (440) 647-0712

Interoperability endpoints

  • Direct secure messaging: tina.mitterling@779530956636164.direct.elationemr.com
  • Direct secure messaging: tina.mitterling@521861120327684.direct.elationemr.com

Organizations & group practices 10

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1188950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760918400000",
    "number": "1427242239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 GATEWAY CENTER WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921024541",
            "telephone_number": "619-515-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3705 MISSION BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921097104",
            "telephone_number": "619-515-2444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITTERLING",
        "first_name": "TINA",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-05",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "67090",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "1235",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0595PA",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3025372",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0077981",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.