Marc E Kobernick, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

G52533 Issued in CA

Practice address

10240 Winecreek CT
San Diego, CA 92127-3728

Phone

(858) 774-4468

NPI assigned

Jul 11, 2006

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

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

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.

• Team Physicians of Northern California Medical Group Inc

  • Emergency Medicine Physician
  • Pleasanton, CA
  • NPI 1649692716
  Medicare reassignment NPD
• Grossmont Emergency Medical Group

  • Emergency Medicine Physician
  • La Mesa, CA
  • NPI 1861437501
  NPD (past)

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1629003637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10240 WINECREEK CT",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921273728",
            "telephone_number": "858-774-4468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10240 WINECREEK CT",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921273728",
            "telephone_number": "858-774-4468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOBERNICK",
        "first_name": "MARC",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G52533",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G525330",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan Ko, RPH
• Yi-Chun Ko, DTCM, L.AC
• Danielle Kobata
• Kyohei Kobayashi
• Leslie M Kobayashi, M.D.
• Lexie Kobey, NONE
• April Jean Kobishop Knutson, RN
• Helen Sandra Kobold, LMFT
• Chloe Jade Kobus
• David Koch, BCBA

• Emergency Medicine Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.