Individual provider Active NPI

Andrea Lynn Munoz, PAC

  • Medical Physician Assistant
  • Del Mar, CA
National Provider Identifier
1528165271
Registry record updated Apr 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA17566 Issued in CA
Practice address
2600 Via de la Valle
Ste 200
Del Mar, CA 92014-1992
Phone
(858) 309-3116
Fax
(858) 309-3139
NPI assigned
Sep 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA17566 CA Primary

Addresses

Primary practice location

2600 Via de la Valle
Ste 200
Del Mar, CA 92014-1992

Mailing address

2600 Via de la Valle
Ste 200
Del Mar, CA 92014-1992
Phone (858) 309-3116

Other identifiers 1

IdentifierTypeStateIssuer
330454950OtherCAGROUP ID#

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140721002507 CA Practitioner - Physician Assistant 8022234467 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sharp Rees-Stealy Medical Group IncGroup PAC ID 8628972759, 872 clinicians

Practice addresses (Care Compare)

10670 Wexford St
San Diego, CA 92131-3940
Phone (858) 621-4002

2600 Via de la Valle
Suite 200
Del Mar, CA 92014-1992
Phone (858) 499-2600

Merit-based Incentive Payment System (MIPS)

Final score
88.67 of 100Reported as group
Quality
81.04
Promoting interoperability
99
Improvement activities
40
Cost
82.04

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
17566CAMDClinical Psychologist
PA17566CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince May 14, 2014 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince May 14, 2014 Accepting new patients
Sharp Memorial Hospital Past Accepting new patients
Sharp Rees-Stealy Medical Center Past Accepting new patients

Locations

2600 Via de la Valle
Ste 200
Del Mar, CA 92014
Phone (858) 309-3160

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

5651 Copley Dr
Ste A
San Diego, CA 92111
Phone (858) 262-6109

Interoperability endpoints

  • Direct secure messaging: amunoz22297@sharphealthcare.direct-ci.com

Organizations & group practices 4

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": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492560000000",
    "number": "1528165271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 VIA DE LA VALLE",
            "address_2": "STE 200",
            "city": "DEL MAR",
            "state": "CA",
            "postal_code": "920141992",
            "telephone_number": "858-309-3116",
            "fax_number": "858-309-3139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 VIA DE LA VALLE",
            "address_2": "STE 200",
            "city": "DEL MAR",
            "state": "CA",
            "postal_code": "920141992",
            "telephone_number": "858-309-3116",
            "fax_number": "858-309-3139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNOZ",
        "first_name": "ANDREA",
        "middle_name": "LYNN",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-17",
        "last_updated": "2017-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA17566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP  ID#",
            "identifier": "330454950",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Del Mar, CA

Sources for this page

Verify at the official NPI Registry.