Organization Active NPI

Richard a Mayer MD Inc

  • Infectious Disease Physician
  • San Diego, CA
National Provider Identifier
1487753448
Registry record updated Jan 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
Legal business name
RICHARD A MAYER MD INC
Practice address
4231 Balboa Ave Ste 218
San Diego, CA 92117-5504
Phone
(619) 754-4955
Fax
(619) 287-9058
NPI assigned
Sep 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2019

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

Authorized official

Name
Richard Andrew Mayer, M.D.NPI 1689773640
Title
President
Phone
(619) 462-9010

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RI0200X Primary

Addresses

Primary practice location

4231 Balboa Ave Ste 218
San Diego, CA 92117-5504

Mailing address

4231 Balboa Ave Ste 218
San Diego, CA 92117-5504
Phone (619) 462-9010

Other practice location 1

6699 Alvarado Rd
Suite 2308
San Diego, CA 92120-5241
Phone (619) 462-9010

Other identifiers 2

IdentifierTypeStateIssuer
00A792460MedicaidCA
WA79246COtherPROVIDER TRANSACTION ACCESS NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041116000336 CA Part B Supplier - Clinic/Group Practice 5991769382 Receives reassigned benefits from 1 practitioner
Practice locations: San Diego, CA

National Provider Directory

National Provider Directory

Locations

4231 Balboa Ave
San Diego, CA 92117
Phone (858) 377-6941

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547683200000",
    "number": "1487753448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4231 BALBOA AVE STE 218",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921175504",
            "telephone_number": "619-462-9010",
            "fax_number": "619-287-9058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4231 BALBOA AVE STE 218",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921175504",
            "telephone_number": "619-754-4955",
            "fax_number": "619-287-9058"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6699 ALVARADO RD",
            "address_2": "SUITE 2308",
            "address_purpose": "LOCATION",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921205241",
            "country_code": "US",
            "telephone_number": "619-462-9010",
            "fax_number": "619-287-9058",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RICHARD A MAYER MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2019-01-17",
        "status": "A",
        "authorized_official_last_name": "MAYER",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-462-9010",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A792460",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER TRANSACTION ACCESS NUMBER",
            "identifier": "WA79246C",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.