Individual provider Active NPI

Joel Justin Baranski, M.D.

  • Nephrology Physician
  • San Diego, CA
National Provider Identifier
1548265234
Registry record updated Jun 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
G67559 Issued in CA
Practice address
4060 4TH Ave
Ste 220
San Diego, CA 92103-2120
Phone
(619) 299-2350
Fax
(619) 297-8379
NPI assigned
Jun 17, 2005
Last updated
Jun 28, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X G67559 CA Primary

Addresses

Primary practice location

4060 4TH Ave
Ste 220
San Diego, CA 92103-2120

Mailing address

4225 Executive SQ Ste 450
La Jolla, CA 92037-8411
Phone (858) 810-0000

Other practice location 1

4094 4th Ave
San Diego, CA 92103-2143
Phone (619) 515-2545

Other identifiers 3

IdentifierTypeStateIssuer
DX113YOtherCANO. CALIFORNIA PTAN
WG675590OtherCASO. CALIFORNIA PTAN
00G675590MedicaidCA

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
I20040415001081 CA Practitioner - NephrologyPractitioner - Internal Medicine 4385639764 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers of San Diego, Inc CurrentSince Jul 1, 2024 Accepting new patients
Family Health Centers of San Diego, Inc Current Accepting new patients
Scripps Health Current Accepting new patients
Family Health Centers of San Diego Inc Current Accepting new patients
San Diego Hospital Based Physicians Medical Association Past Accepting new patients

Locations

4065 3rd Ave
Ste 200
San Diego, CA 92103
Phone (619) 299-2350

4094 4th Ave
San Diego, CA 92103
Phone (619) 515-2545

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

Interoperability endpoints

  • Direct secure messaging: jbaranski26975@scrippshlth.medalliesdirect.net

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": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656374400000",
    "number": "1548265234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4225 EXECUTIVE SQ STE 450",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920378411",
            "telephone_number": "858-810-0000",
            "fax_number": "858-268-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4060 4TH AVE",
            "address_2": "STE 220",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032120",
            "telephone_number": "619-299-2350",
            "fax_number": "619-297-8379"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4094 4th Ave",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921032143",
            "country_code": "US",
            "telephone_number": "619-515-2545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARANSKI",
        "first_name": "JOEL",
        "middle_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-17",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "G67559",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NO. CALIFORNIA PTAN",
            "identifier": "DX113Y",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SO. CALIFORNIA PTAN",
            "identifier": "WG675590",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G675590",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.