Individual provider Active NPI

Abha M Bosworth, PA

  • Physician Assistant
  • La Jolla, CA
National Provider Identifier
1629067053
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA16657 Issued in CA
Practice address
9300 Campus Point Dr
La Jolla, CA 92037-1300
Phone
(800) 926-8273
NPI assigned
Oct 18, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA16657 CA Primary

Addresses

Primary practice location

9300 Campus Point Dr
La Jolla, CA 92037-1300

Mailing address

File 57326
Los Angeles, CA 90074-0001

Other practice location 1

8860 Center Dr
Suite 330
LA Mesa, CA 91942-3068
Phone (619) 460-4055

Other practice location 2

4303 La Jolla Village Dr
San Diego, CA 92122-1394
Phone (800) 926-8273

Other practice location 3

200 W Arbor Dr
San Diego, CA 92103-9000
Phone (800) 926-8273

Other identifiers 1

IdentifierTypeStateIssuer
1629067053OtherCAMEDICARE NPI

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090522000343 CA Practitioner - Physician Assistant 2769531607 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

200 W Arbor Dr
San Diego, CA 92103-9000
Phone (858) 657-7000

9300 Campus Point Dr
La Jolla, CA 92037-1300
Phone (858) 657-7000

9350 Campus Point Dr
La Jolla, CA 92037-1300
Phone (858) 657-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA16657CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Sep 25, 2011 Accepting new patients
Southern California Permanente Medical Group CurrentSince Sep 25, 2011 Accepting new patients
Regents of the University of California CurrentSince Nov 4, 2024 Accepting new patients
Regents of the University of California - Ucsd Medical Group CurrentSince Nov 4, 2024 Accepting new patients
Regents of the University of California Ucsd Head and Neck Surgery Past Accepting new patients

Locations

9300 Campus Point Dr
La Jolla, CA 92037
Phone (619) 957-7000

File 57326
Los Angeles, CA 90074

4647 Zion Ave
San Diego, CA 92120
Phone (619) 528-3038

4303 La Jolla Village Dr
Ste 2110
San Diego, CA 92122
Phone (858) 657-8857

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

Interoperability endpoints

  • Direct secure messaging: abosworth32465@sharphealthcare.direct-ci.com

Organizations & group practices 8

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 1

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": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1629067053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FILE 57326",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900740001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 CAMPUS POINT DR",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371300",
            "telephone_number": "800-926-8273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8860 Center Dr",
            "address_2": "SUITE 330",
            "address_purpose": "LOCATION",
            "city": "LA Mesa",
            "state": "CA",
            "postal_code": "919423068",
            "country_code": "US",
            "telephone_number": "619-460-4055",
            "fax_number": "619-460-5148",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4303 La Jolla Village Dr",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921221394",
            "country_code": "US",
            "telephone_number": "800-926-8273",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 W Arbor Dr",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921039000",
            "country_code": "US",
            "telephone_number": "800-926-8273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOSWORTH",
        "first_name": "ABHA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-18",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA16657",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NPI",
            "identifier": "1629067053",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

Verify at the official NPI Registry.