Individual provider Active NPI

Richard William Novotny, M.D

  • Family Medicine Physician
  • San Diego, CA
National Provider Identifier
1588002877
Registry record updated May 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A143811 Issued in CA
Practice address
200 W Arbor Dr
San Diego, CA 92103-9000
Phone
(619) 471-9260
NPI assigned
Jun 7, 2013
Last updated
May 5, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2017

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 A143811 CA Primary

Addresses

Primary practice location

200 W Arbor Dr
San Diego, CA 92103-9000

Mailing address

PO Box 232410
San Diego, CA 92193-2410
Phone (858) 249-6748

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
I20161109001625 CA Practitioner - Family Practice 5092094326 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A143811CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California Current Accepting new patients
Regents of the University of California CurrentSince Sep 26, 2016 Accepting new patients
Regents of the University of California Family Medicine CurrentSince Sep 26, 2016 Accepting new patients
Regents of the University of California Past Accepting new patients
Scripps Health Past Accepting new patients

Locations

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

330 Lewis St
San Diego, CA 92103
Phone (619) 471-9235

330 Lewis St
Ste 400
San Diego, CA 92103
Phone (619) 471-9250

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1370563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493942400000",
    "number": "1588002877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 232410",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921932410",
            "telephone_number": "858-249-6748",
            "fax_number": "619-543-3183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000",
            "telephone_number": "619-471-9260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVOTNY",
        "first_name": "RICHARD",
        "middle_name": "WILLIAM",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-07",
        "last_updated": "2017-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A143811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.