Individual provider Active NPI

Janos Taller, MD

  • Surgery Physician
  • San Diego, CA
National Provider Identifier
1518028729
Registry record updated Nov 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A62642 Issued in CA
Practice address
34800 Bob Wilson Dr
Nmcsd, Departtment of Surgery
San Diego, CA 92134-1098
Phone
(619) 532-7577
NPI assigned
Dec 12, 2006
Last updated
Nov 17, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A62642 CA Primary

Addresses

Primary practice location

34800 Bob Wilson Dr
Nmcsd, Departtment of Surgery
San Diego, CA 92134-1098

Mailing address

6365 Lake Kathleen Ave
San Diego, CA 92119-3130
Phone (619) 741-3297

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20041014001121 CA Practitioner - General SurgeryPractitioner - Emergency Medicine 3678533585 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A62642CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Mar 11, 2013 Accepting new patients
Scripps Health Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Mar 11, 2013 Accepting new patients
Emergency and Acute Care Medical Corporation CurrentSince Sep 13, 2010 Accepting new patients
Scripps Health Current Accepting new patients
Scripps Health CurrentSince May 5, 2009 Accepting new patients
Scripps Health CurrentSince May 5, 2009 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Scripps Health Current Accepting new patients
Scripps Health Past Accepting new patients
Palomar Health Past Accepting new patients
North County Trauma Associates, Inc. a Medical Group Surgery PastSince Sep 1, 2017 Accepting new patients
Hillcrest Surgical Medical Group, Inc. Past Accepting new patients

Locations

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

File 54433
Los Angeles, CA 90074
Phone (858) 784-5645

393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914

4060 4th Ave
Ste 330
San Diego, CA 92103
Phone (619) 291-2274

4647 Zion Ave
San Diego, CA 92120
Phone (619) 528-3038

7901 Frost St
San Diego, CA 92123
Phone (619) 541-3400

Interoperability endpoints

  • Direct secure messaging: jtaller81658@scrippshlth.medalliesdirect.net

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637107200000",
    "number": "1518028729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6365 LAKE KATHLEEN AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921193130",
            "telephone_number": "619-741-3297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34800 BOB WILSON DR",
            "address_2": "NMCSD, DEPARTTMENT OF SURGERY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921341098",
            "telephone_number": "619-532-7577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALLER",
        "first_name": "JANOS",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A62642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4647 Zion Ave",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921202507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.