Organization Active NPI

Pacific Endocrinology

  • Endocrinology, Diabetes & Metabolism Physician
  • San Diego, CA
National Provider Identifier
1619502572
Registry record updated Mar 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
PACIFIC ENDOCRINOLOGY
Practice address
1855 1St Ave Ste 200B
San Diego, CA 92101-2685
Phone
(619) 432-1033
Fax
(619) 310-5426
NPI assigned
Mar 11, 2020
Last updated
Mar 17, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2020

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

Authorized official

Name
Lisa Strahm, MDNPI 1952708075
Title
Ceo
Phone
(619) 432-1033

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RE0101X Primary

Addresses

Primary practice location

1855 1St Ave Ste 200B
San Diego, CA 92101-2685

Mailing address

1855 1St Ave Ste 200B
San Diego, CA 92101-2685

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200515001922 CA Part B Supplier - Clinic/Group Practice 0648601179 Receives reassigned benefits from 1 practitioner
Practice locations: San Diego, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1583884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584403200000",
    "number": "1619502572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1855 1ST AVE STE 200B",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921012685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1855 1ST AVE STE 200B",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921012685",
            "telephone_number": "619-432-1033",
            "fax_number": "619-310-5426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC ENDOCRINOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-11",
        "last_updated": "2020-03-17",
        "certification_date": "2020-03-17",
        "status": "A",
        "authorized_official_last_name": "STRAHM",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "619-432-1033",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.