Individual provider Active NPI

Debbie Tanedo, PA-C

  • Physician Assistant
  • San Diego, CA
National Provider Identifier
1598170862
Registry record updated Sep 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
15004 Innovation Dr
San Diego, CA 92128-3491
Phone
(858) 554-7439
NPI assigned
Jun 25, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

15004 Innovation Dr
San Diego, CA 92128-3491

Mailing address

15004 Innovation Dr
San Diego, CA 92128-3491
Phone (858) 554-7439

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
I20150327001698 CA Practitioner - Physician Assistant 4183941396 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Scripps HealthGroup PAC ID 9234033853, 1,450 clinicians

Practice addresses (Care Compare)

3811 Valley Centre Dr
San Diego, CA 92130-3318
Phone (858) 764-3000

9888 Genesee Ave
La Jolla, CA 92037-1205
Phone (858) 626-4123

9896 Genesee Ave
La Jolla, CA 92037-1205
Phone (858) 626-4123

9898 Genesee Ave
La Jolla, CA 92037-1205
Phone (858) 455-9100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health CurrentSince Jun 1, 2016 Accepting new patients
Scripps Health Physician Assistant CurrentSince Jun 1, 2016 Accepting new patients
Scripps Health Current Accepting new patients
Scripps Health Current Accepting new patients
Memorial Medical Group Inc Past Accepting new patients
Scripps Clinic Medical Group Past Accepting new patients

Locations

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

10666 N Torrey Pines Rd
La Jolla, CA 92037
Phone (858) 554-2626

File 54433
Los Angeles, CA 90074
Phone (858) 784-5645

15004 Innovation Dr
San Diego, CA 92128
Phone (858) 487-1800

3811 Valley Centre Dr
San Diego, CA 92130
Phone (858) 554-8645

10790 Rancho Bernardo Rd
#4S
San Diego, CA 92127

4350 La Jolla Village Dr
Ste 130
San Diego, CA 92122
Phone (858) 678-6781

Interoperability endpoints

  • Direct secure messaging: dtanedo19704@scrippshlth.medalliesdirect.net
  • Direct secure messaging: debbie.tanedo@166622370791428.direct.elationemr.com

Organizations & group practices 7

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.

Hospital & facility affiliations 3

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": "1403654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599609600000",
    "number": "1598170862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15004 INNOVATION DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921283491",
            "telephone_number": "858-554-7439"
        },
        {
            "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": "921283491",
            "telephone_number": "858-554-7439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANEDO",
        "first_name": "DEBBIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-25",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.