Individual provider Active NPI

Nicholas Joseph Gloude, MD

  • Pediatric Hematology & Oncology Physician
  • San Diego, CA
National Provider Identifier
1447527833
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X
License
A119146 Issued in CA
Practice address
3010 Childrens Way FL 2
San Diego, CA 92123-4223
Phone
(858) 966-5811
NPI assigned
Nov 29, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Hematology & Oncology Physician 2080P0207X 35.128362 OH
Pediatric Hematology & Oncology Physician 2080P0207X A119146 CA Primary

Addresses

Primary practice location

3010 Childrens Way FL 2
San Diego, CA 92123-4223

Mailing address

3020 Children'S Way
MC 5003
San Diego, CA 92123-4223
Phone (858) 309-6300

Other practice location 1

3333 Burnet Ave
Cincinnati, OH 45229-3026
Phone (513) 636-4266

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20170817003700 CA Practitioner - Hematology/OncologyPractitioner - Pediatric Medicine 2668744178 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Pediatric Medicine
Education
Rush Medical College of Rush University, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3010 Childrens Way
San Diego, CA 92123-4223
Phone (858) 576-1700

3020 Children'S Way
San Diego, CA 92123-4223
Phone (858) 576-1700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
119146CAMDSocial Worker
A119146CAMDPediatric Hematology & Oncology Physician
35.128362OHMDPediatric Hematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Marilyn Kaufhold, M.D., a Medical Corporation PastSince Jul 24, 2022 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ngloude134145@radychildrens.direct-ci.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1322524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1447527833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 CHILDREN'S WAY",
            "address_2": "MC 5003",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234223",
            "telephone_number": "858-309-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3010 CHILDRENS WAY FL 2",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234223",
            "telephone_number": "858-966-5811"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3333 Burnet Ave",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452293026",
            "country_code": "US",
            "telephone_number": "513-636-4266",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLOUDE",
        "first_name": "NICHOLAS",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-29",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "OH",
            "license": "35.128362",
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "CA",
            "license": "A119146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.