Individual provider Active NPI

Alissa Bartlett, NP

  • Pediatric Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1548073620
Registry record updated Feb 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
95032813 Issued in CA
Practice address
15004 Innovation Dr
San Diego, CA 92128-3498
Phone
(858) 554-7272
NPI assigned
Jan 31, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 95032813 CA Primary

Addresses

Primary practice location

15004 Innovation Dr
San Diego, CA 92128-3498

Mailing address

10790 Rancho Bernardo Rd
San Diego, CA 92127-5705
Phone (858) 554-7272

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
I20250325000259 CA Practitioner - Nurse Practitioner 3779006382 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95032813CAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Monica Perlman MD Inc. CurrentSince Sep 8, 2025 Accepting new patients
UC San Diego Health - Rancho Family Medical Group Past Accepting new patients

Locations

9850 Genesee Ave
Ste 320
La Jolla, CA 92037
Phone (858) 864-9800

2790 Truxtun Rd
Ste 120A
San Diego, CA 92106
Phone (619) 222-1253

3737 Moraga Ave
Ste B103
San Diego, CA 92117
Phone (858) 799-0855

3900 5th Ave
Ste 110
San Diego, CA 92103
Phone (619) 291-5474

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1738281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738800000000",
    "number": "1548073620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10790 RANCHO BERNARDO RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275705",
            "telephone_number": "858-554-7272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15004 INNOVATION DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921283498",
            "telephone_number": "858-554-7272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTLETT",
        "first_name": "ALISSA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-31",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "95032813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.