Individual provider Active NPI

Isela Penunuri, MD

  • Family Medicine Physician
  • San Marcos, CA
National Provider Identifier
1548295439
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A88564 Issued in CA
Practice address
277 Rancheros Dr Ste 100
San Marcos, CA 92069-2959
Phone
(760) 291-6700
Fax
(760) 471-0513
NPI assigned
Jul 11, 2006
Last updated
Dec 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A88564 CA Primary

Addresses

Primary practice location

277 Rancheros Dr Ste 100
San Marcos, CA 92069-2959

Mailing address

225 East Second Avenue
Escondido, CA 92025-4249
Phone (760) 291-6700

Other identifiers 1

IdentifierTypeStateIssuer
CB241807OtherCAMEDICARE PTAN

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
I20041206000527 CA Practitioner - Family Practice 7315903994 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Graybill Medical Group IncGroup PAC ID 9335050517, 103 clinicians

Practice addresses (Care Compare)

277 Rancheros Dr
Suite 100
San Marcos, CA 92069-2959
Phone (866) 228-2236

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Graybill Medical Group Inc Family Medicine CurrentSince Sep 8, 2015 Accepting new patients
Palomar Health Past Accepting new patients

Locations

225 E 2nd Ave
Escondido, CA 92025

332 S Juniper St
Ste 100
Escondido, CA 92025
Phone (760) 291-6650

277 Rancheros Dr
Ste 100
San Marcos, CA 92069
Phone 86622822368106

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1548295439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 EAST SECOND AVENUE",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920254249",
            "telephone_number": "760-291-6700",
            "fax_number": "760-737-7324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "277 RANCHEROS DR STE 100",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920692959",
            "telephone_number": "760-291-6700",
            "fax_number": "760-471-0513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENUNURI",
        "first_name": "ISELA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A88564",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "CB241807",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Marcos, CA

Sources for this page

Verify at the official NPI Registry.