Individual provider Active NPI

Andrew R Deemer, MD

  • Vascular Surgery Physician
  • Oceanside, CA
National Provider Identifier
1578568432
Registry record updated Nov 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
G66191 Issued in CA
Practice address
3998 Vista Way
Ste C200
Oceanside, CA 92056-4519
Phone
(760) 724-5352
Fax
(760) 724-5447
NPI assigned
Jun 16, 2005
Reactivated
Mar 24, 2006
Last updated
Nov 12, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X G66191 CA Primary

Addresses

Primary practice location

3998 Vista Way
Ste C200
Oceanside, CA 92056-4519

Mailing address

3998 Vista Way
Ste C200
Oceanside, CA 92056-4519
Phone (760) 724-5352

Other identifiers 1

IdentifierTypeStateIssuer
00G661910MedicaidCA

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
I20110225000593 CA Practitioner - General Surgery 5294734570 Practice locations: Oceanside, CA

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3601 W Vista Way
Suite 203
Oceanside, CA 92056-4559
Phone (760) 724-5352

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Melanoma (skin cancer) excision1-10
Leg revascularization (restoring blood flow)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G66191CAMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Current Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: adeemer61421@scrippshlth.medalliesdirect.net
  • Direct secure messaging: andrew.deemer.p2@direct.csmgvmed.nextgenshare.com

Organizations & group practices 1

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": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384214400000",
    "number": "1578568432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3998 VISTA WAY",
            "address_2": "STE C200",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920564519",
            "telephone_number": "760-724-5352",
            "fax_number": "760-724-5447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3998 VISTA WAY",
            "address_2": "STE C200",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920564519",
            "telephone_number": "760-724-5352",
            "fax_number": "760-724-5447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEEMER",
        "first_name": "ANDREW",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2013-11-12",
        "deactivation_date": "2006-03-20",
        "reactivation_date": "2006-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "CA",
            "license": "G66191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G661910",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, CA

Sources for this page

Verify at the official NPI Registry.