Individual provider Active NPI

Sharon Marie Dreeben, M.D.

  • Orthopaedic Foot and Ankle Surgery Physician
  • San Diego, CA
National Provider Identifier
1457387250
Registry record updated Jul 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Foot and Ankle Surgery PhysicianTaxonomy code 207XX0004X
License
G67534 Issued in CA
Practice address
9339 Genesee Ave
Suite 150
San Diego, CA 92121-2119
Phone
(858) 625-7979
Fax
(858) 625-2020
NPI assigned
Jun 23, 2006
Last updated
Jul 2, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Foot and Ankle Surgery Physician 207XX0004X G67534 CA Primary

Addresses

Primary practice location

9339 Genesee Ave
Suite 150
San Diego, CA 92121-2119

Mailing address

9339 Genesee Ave
Suite 150
San Diego, CA 92121-2119
Phone (858) 625-7979

Other identifiers 1

IdentifierTypeStateIssuer
00G675340MedicaidCA

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
I20210202000161 CA Order and Referring Only - Orthopedic SurgeryPractitioner - Orthopedic Surgery 3678523750

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
67534CAMDPharmacist
G67534CAMDOrthopaedic Foot and Ankle Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Disorders of the Foot and Ankle Foot and Ankle Surgery PastSince Jan 3, 2001 Accepting new patients
Synergy Orthopedic Specialists, Inc. Foot and Ankle Surgery PastSince Sep 1, 2015 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435795200000",
    "number": "1457387250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9339 GENESEE AVE",
            "address_2": "SUITE 150",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921212119",
            "telephone_number": "858-625-7979",
            "fax_number": "858-625-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9339 GENESEE AVE",
            "address_2": "SUITE 150",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921212119",
            "telephone_number": "858-625-7979",
            "fax_number": "858-625-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DREEBEN",
        "first_name": "SHARON",
        "middle_name": "MARIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-23",
        "last_updated": "2015-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0004X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "CA",
            "license": "G67534",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G675340",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.