Individual provider Active NPI

Tyler David Brobst, MD

  • Pediatrics Physician
  • San Diego, CA
National Provider Identifier
1598290645
Registry record updated Sep 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A157353 Issued in CA
Practice address
2790 Truxtun Rd Ste 120a
San Diego, CA 92106-6135
Phone
(619) 222-1253
Fax
(858) 795-1195
NPI assigned
Apr 26, 2017
Last updated
Sep 13, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Pediatrics Physician 208000000X A157353 CA Primary

Addresses

Primary practice location

2790 Truxtun Rd Ste 120a
San Diego, CA 92106-6135

Mailing address

9850 Genesee Ave Ste 320
La Jolla, CA 92037-1208
Phone (858) 554-1212

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
I20200828000923 CA Practitioner - Pediatric Medicine 9739506205 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
92.17 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
73.9

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A157353CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Aug 24, 2020 Accepting new patients
Monica Perlman MD Inc. CurrentSince Oct 1, 2022 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc Pediatrics CurrentSince Aug 24, 2020 Accepting new patients
UC San Diego Health - Rancho Family Medical Group Past Accepting new patients
Regents of the University of California Past Accepting new patients
Rady Children's Hospital San Diego Past Accepting new patients

Locations

9850 Genesee Ave
Ste 320
La Jolla, CA 92037
Phone (858) 864-9800

5525 Grossmont Center Dr
La Mesa, CA 91942
Phone (619) 644-6600

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

2790 Truxtun Rd
Ste 120A
San Diego, CA 92106
Phone (619) 222-1253

3737 Moraga Ave
Ste B103
San Diego, CA 92117
Phone (858) 799-0855

5651 Copley Dr
Ste A
San Diego, CA 92111
Phone (858) 262-6666

Organizations & group practices 6

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": "1493164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663027200000",
    "number": "1598290645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9850 GENESEE AVE STE 320",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371208",
            "telephone_number": "858-554-1212",
            "fax_number": "858-795-1195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2790 TRUXTUN RD STE 120A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921066135",
            "telephone_number": "619-222-1253",
            "fax_number": "858-795-1195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROBST",
        "first_name": "TYLER",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-26",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A157353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.