Individual provider Active NPI

Ellen J Deloya, DO

  • Family Medicine Physician
  • San Diego, CA
National Provider Identifier
1457934648
Registry record updated Aug 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A23860 Issued in CA
Practice address
16899 W Bernardo Dr
San Diego, CA 92127-1603
Phone
(858) 499-2705
NPI assigned
May 4, 2021
Last updated
Aug 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MRO-2047 ID
Family Medicine Physician 207Q00000X O-1753 ID
Family Medicine Physician 207Q00000X 20A23860 CA Primary

Addresses

Primary practice location

16899 W Bernardo Dr
San Diego, CA 92127-1603

Mailing address

16899 W Bernardo Dr
San Diego, CA 92127-1603
Phone (858) 499-2705

Other practice location 1

85 S Middleton Rd
Nampa, ID 83651-1526
Phone (208) 505-2800

Other practice location 2

9850 W St Lukes Dr Ste 329
Nampa, ID 83687-7912
Phone (208) 514-2509

Other practice location 3

215 E Hawaii Ave Ste 260
Nampa, ID 83686-6011
Phone (208) 514-2529

Other names 1

  • Ellen J Douglass Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240716002655 ID Practitioner - Family Practice 3173925278 Reassigns benefits to 1 organization
I20250815002961 CA Practitioner - Family Practice 3173925278 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sharp Rees-Stealy Medical Group IncGroup PAC ID 8628972759, 872 clinicians
St Lukes Clinic-Treasure Valley LLCGroup PAC ID 4981878402, 1,155 clinicians

Practice addresses (Care Compare)

16899 W Bernardo Dr
San Diego, CA 92127-1603
Phone (858) 499-2600

85 S Middleton Rd
Nampa, ID 83651-1526
Phone (208) 505-2800

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
81.29
Promoting interoperability
100
Improvement activities
40
Cost
76.37

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Aug 4, 2025 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc Family Medicine CurrentSince Aug 4, 2025 Accepting new patients
St Lukes Clinic-Treasure Valley LLC Family Medicine CurrentSince Jul 1, 2024 Accepting new patients
St Lukes Clinic-Treasure Valley LLC Family Medicine CurrentSince Jul 1, 2024 Accepting new patients
Sharp Rees-Stealy Medical Center Past Accepting new patients

Locations

16899 W Bernardo Dr
San Diego, CA 92127
Phone (858) 499-2705

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

5651 Copley Dr
Ste A
San Diego, CA 92111
Phone (858) 262-6666

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

610 W Hays St
Boise, ID 83702
Phone (208) 345-3530

215 E Hawaii Ave
Ste 260
Nampa, ID 83686
Phone (208) 514-2529

85 S Middleton Rd
Nampa, ID 83651
Phone (208) 381-4100

9850 W St Lukes Dr
Ste 329
Nampa, ID 83687
Phone (208) 331-1155

Organizations & group practices 5

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": "1620086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755043200000",
    "number": "1457934648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16899 W BERNARDO DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921271603",
            "telephone_number": "858-499-2705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16899 W BERNARDO DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921271603",
            "telephone_number": "858-499-2705"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "85 S Middleton Rd",
            "address_purpose": "LOCATION",
            "city": "Nampa",
            "state": "ID",
            "postal_code": "836511526",
            "country_code": "US",
            "telephone_number": "208-505-2800",
            "fax_number": "208-505-2801",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9850 W St Lukes Dr Ste 329",
            "address_purpose": "LOCATION",
            "city": "Nampa",
            "state": "ID",
            "postal_code": "836877912",
            "country_code": "US",
            "telephone_number": "208-514-2509",
            "fax_number": "208-375-2217",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "215 E Hawaii Ave Ste 260",
            "address_purpose": "LOCATION",
            "city": "Nampa",
            "state": "ID",
            "postal_code": "836866011",
            "country_code": "US",
            "telephone_number": "208-514-2529",
            "fax_number": "208-375-2217",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DELOYA",
        "first_name": "ELLEN",
        "middle_name": "J",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-04",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "MRO-2047",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "O-1753",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A23860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELLEN",
            "last_name": "DOUGLASS",
            "middle_name": "J",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.