Diana M Breister, M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

A55510 Issued in CA

Practice address

2275 Rio Bonito Way
Suite 220
San Diego, CA 92108-1685

Phone

(619) 822-1667

Fax

(619) 684-1730

NPI assigned

Nov 14, 2005

Last updated

Feb 3, 2012By the provider in NPPES

Sex

Female

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 3

Other names 1

• Diana Breister Ghosh Other name

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)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Emergency and Acute Care Medical Corporation

  • Emergency Medicine Physician
  • San Diego, CA
  • NPI 1437103942
  Medicare reassignment NPD
• Grossmont Hospital Corporation

  dba Sharp Grossmont Hospital

  • General Acute Care Hospital
  • La Mesa, CA
  • NPI 1528041811
  NPD (past)
• Sharp Memorial Hospital

  dba Sharp Allison deRose Rehabilitation Center

  • Rehabilitation Hospital Unit
  • San Diego, CA
  • NPI 1114901352
  NPD (past)

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328227200000",
    "number": "1629050943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2275 RIO BONITO WAY",
            "address_2": "SUITE 220",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081685",
            "telephone_number": "619-822-1667",
            "fax_number": "619-684-1730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2275 RIO BONITO WAY",
            "address_2": "SUITE 220",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081685",
            "telephone_number": "619-822-1667",
            "fax_number": "619-684-1730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREISTER",
        "first_name": "DIANA",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-14",
        "last_updated": "2012-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "A55510",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE 2",
            "identifier": "1396046454",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A555101",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "A55510",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANA",
            "last_name": "BREISTER GHOSH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Tawni Breedlove
• Adrienne Margaret Breen, MS, OTR/L
• Terrance W. Breen, M.D.
• Elizabeth Brehm
• Stewart Breier, LMT
• Destiny Breitkreutz, DSW, LCSW
• James Breitmeyer
• Allison Brekke, OTR/L
• Elizabeth Ann Scheurn Brekke
• Jonathan Brekke

• Plastic Surgery Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Plastic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.