Douglas Dean Dengerink, D.O.

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

20A9206 Issued in CA

Practice address

6699 Alvarado Rd
Suite 2100
San Diego, CA 92120-5244

Phone

(619) 229-3909

Fax

(619) 229-3902

NPI assigned

Jun 24, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Family PracticeAlso: Sports Medicine

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

SD Sports Medicine and Family Health CenterGroup PAC ID 7113812496, 38 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Grossmont Hospital Hospital, La Mesa, CA, CCN 050026

Merit-based Incentive Payment System (MIPS)

Final score

90.4 of 100Reported as group

Quality

93.75

Promoting interoperability

100

Improvement activities

40

Cost

74.23

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• SD Sports Medicine and Family Health Center

  • Multi-Specialty Clinic/Center
  • San Diego, CA
  • NPI 1669472510
  Medicare reassignment Care Compare group NPD
• Regents of the University of California

  • Pharmacy
  • San Diego, CA
  • NPI 1598786576
  NPD (past)
• Regents of the University of California

  • Family Medicine Physician
  • San Diego, CA
  • NPI 1790179539
  NPD (past)

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

• Grossmont Hospital Corporation

  • General Acute Care Hospital
  • La Mesa, CA
  • NPI 1528041811
  Care Compare affiliation

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347494400000",
    "number": "1598761413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6699 ALVARADO RD",
            "address_2": "SUITE 2100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921205244",
            "telephone_number": "619-229-3909",
            "fax_number": "619-229-3902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6699 ALVARADO RD",
            "address_2": "SUITE 2100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921205244",
            "telephone_number": "619-229-3909",
            "fax_number": "619-229-3902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENGERINK",
        "first_name": "DOUGLAS",
        "middle_name": "DEAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-24",
        "last_updated": "2012-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "CA",
            "license": "20A9206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "GL046Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew John Denevan, PA-C
• Lily Shang Deng
• Mimi Deng
• Nyadak Tut Deng
• Daniel Adan Denge
• Kathleen Dengerink, M.A., BCBA
• Latisha Jenise Denham
• Matthew Denick, HHP, BCLMT
• Dale Denio, D,D.S., M.S.
• Marie G Denis

• Sports Medicine (Family Medicine) Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Sports Medicine (Family Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.