NPIMap

Individual provider Active NPI

Joseph R Novencido, D.O.

  • Family Medicine Physician
  • National City, CA
National Provider Identifier
1619239118
Registry record updated Nov 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A13041 Issued in CA
Practice address
610 Euclid Avenue
Ste 302
National City, CA 91950-2963
Phone
(619) 527-7700
Fax
(619) 527-3226
NPI assigned
Jun 11, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2020

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 20A13041 CA Primary

Addresses

Primary practice location

610 Euclid Avenue
Ste 302
National City, CA 91950-2963

Mailing address

610 Euclid Ave
Ste 302
National City, CA 91950-2951
Phone (619) 527-7700

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address josephnovencido@gmg1.allscriptsdirect.net Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150813012397 CA Practitioner - Family Practice 0244458701 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Gateway Medical Group of San DiegoGroup PAC ID 9830086784, 2 clinicians

Practice addresses (Care Compare)

610 Euclid Ave
Suite 302
National City, CA 91950-2953
Phone (619) 527-7700

Hospital & facility affiliations

  • Modern Home Health Care Inc Home health agency, Chula Vista, CA, CCN 059391
  • Advantage Health Systems Home health agency, San Diego, CA, CCN 058355
  • Sharp Chula Vista Medical Center Hospital, Chula Vista, CA, CCN 050222
  • Grossmont Hospital Hospital, La Mesa, CA, CCN 050026
  • Sharp Memorial Hospital Hospital, San Diego, CA, CCN 050100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A13041CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gateway Medical Group of San Diego Family Medicine CurrentSince Jul 27, 2015 Accepting new patients
Sharp Chula Vista Medical Center Past Accepting new patients
Rady Children'S Hospital San Diego Past Accepting new patients

Locations

752 Medical Center Ct
Ste 210
Chula Vista, CA 91911
Phone (619) 421-3361

610 Euclid Ave
Ste 302
National City, CA 91950
Phone (619) 472-1010

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: jnovencido34080@sharphealthcare.direct-ci.com

Organizations & group practices 3

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 6

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": "1339372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1619239118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 EUCLID AVE",
            "address_2": "STE 302",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919502951",
            "telephone_number": "619-527-7700",
            "fax_number": "619-527-3226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 EUCLID AVENUE",
            "address_2": "STE 302",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919502963",
            "telephone_number": "619-527-7700",
            "fax_number": "619-527-3226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVENCIDO",
        "first_name": "JOSEPH",
        "middle_name": "R",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-11",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A13041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "josephnovencido@gmg1.allscriptsdirect.net",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "610 Euclid Avenue",
            "address_2": "Ste 302",
            "city": "National City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "919502963",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in National City, CA

Sources for this page

Verify at the official NPI Registry.