Individual provider Active NPI

Nicholas Brian Coley, MD/PHD

  • Anatomic Pathology & Clinical Pathology Physician
  • La Jolla, CA
National Provider Identifier
1619396348
Registry record updated Oct 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
A141685 Issued in CA
Practice address
9300 Campus Point Drive
Eastern Campus Office Building
La Jolla, CA 92121
Phone
(858) 657-5463
NPI assigned
Apr 9, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X A141685 CA Primary

Addresses

Primary practice location

9300 Campus Point Drive
Eastern Campus Office Building
La Jolla, CA 92121

Mailing address

10062 Paseo Montril Apt 520
San Diego, CA 92129-3948

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
I20210922003617 CA Practitioner - Pathology 5395142095 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Washington School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Diagnostic Pathology Medical Group IncGroup PAC ID 2860489218, 32 clinicians

Practice addresses (Care Compare)

3301 C St
200E
Sacramento, CA 95816-3363
Phone (916) 446-0424

Hospital & facility affiliations

  • Sutter Medical Center, Sacramento Hospital, Sacramento, CA, CCN 050108
  • Sutter Roseville Medical Center Hospital, Roseville, CA, CCN 050309
  • Sutter Solano Medical Center Hospital, Vallejo, CA, CCN 050101
  • Mercy General Hospital Hospital, Sacramento, CA, CCN 050017
  • Sutter Auburn Faith Hospital Hospital, Auburn, CA, CCN 050498

Merit-based Incentive Payment System (MIPS)

Final score
84.18 of 100Reported as group
Quality
80.24
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A141685CAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Diagnostic Pathology Medical Group, Inc. Anatomic Pathology & Clinical Pathology CurrentSince Nov 14, 2022 Accepting new patients
Diagnostic Pathology Medical Group Inc Anatomic Pathology & Clinical Pathology CurrentSince Nov 14, 2022 Accepting new patients
County of Los Angeles CurrentSince Sep 7, 2021 Accepting new patients
Diagnostic Pathology Medical Group Inc Current Accepting new patients
County of Los Angeles CurrentSince Sep 7, 2021 Accepting new patients
Diagnostic Pathology Medical Group Inc Anatomic Pathology & Clinical Pathology Current Accepting new patients
Lodi Memorial Hospital Association Inc Current Accepting new patients
Diagnostic Pathology Medical Group Inc Anatomic Pathology & Clinical Pathology Past Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
Diagnostic Pathology Medical Group Inc Anatomic Pathology & Clinical Pathology Past Accepting new patients
Diagnostic Pathology Medical Group Inc. Past Accepting new patients
Diagnostic Pathology Medical Group Inc Anatomic Pathology & Clinical Pathology Past Accepting new patients
Diagnostic Pathology Medical Group Inc Anatomic Pathology & Clinical Pathology Past Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
Diagnostic Pathology Medical Group Inc Past Accepting new patients

Locations

11815 Education St
Auburn, CA 95602
Phone (530) 447-6267

2000 Sutter Pl
Davis, CA 95616
Phone (530) 756-6440

975 S Fairmont Ave
Lodi, CA 95240
Phone (209) 339-7575

1 Medical Plaza Dr
Roseville, CA 95661
Phone (916) 781-1000

4001 J St
Sacramento, CA 95819
Phone (916) 453-4037

2420 J St
Sacramento, CA 95816
Phone (916) 446-0424

2825 Capitol Ave
Sacramento, CA 95816
Phone (916) 887-0000

3301 C St
Ste 200E
Sacramento, CA 95816
Phone (916) 446-0424

2801 K St
Ste 235
Sacramento, CA 95816
Phone (916) 733-5073

7500 Hospital Dr
Sacramento, CA 95823
Phone (916) 423-3000

14445 Olive View Dr
Sylmar, CA 91342
Phone (881) 836-4303

300 Hospital Dr
Vallejo, CA 94589
Phone (707) 554-4107

1600 Medical Pkwy
Carson City, NV 89703
Phone (775) 220-9149

Organizations & group practices 16

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.

View all 16

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": "1397001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634256000000",
    "number": "1619396348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10062 PASEO MONTRIL APT 520",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921293948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 CAMPUS POINT DRIVE",
            "address_2": "EASTERN CAMPUS OFFICE BUILDING",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "92121",
            "telephone_number": "858-657-5463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEY",
        "first_name": "NICHOLAS",
        "middle_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "MD/PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-09",
        "last_updated": "2021-10-15",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "A141685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

Verify at the official NPI Registry.