NPIMap

Individual provider Active NPI

Mayra Mendoza Dillon, MD

  • Family Medicine Physician
  • National City, CA
National Provider Identifier
1629232715
Registry record updated Oct 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A112597 Issued in CA
Practice address
1136 D Ave
National City, CA 91950-3412
Phone
(619) 336-2300
Fax
(619) 336-2323
NPI assigned
Jul 17, 2008
Last updated
Oct 5, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A112597 CA Primary

Addresses

Primary practice location

1136 D Ave
National City, CA 91950-3412

Mailing address

4004 Beyer Blvd
San Ysidro, CA 92173-2007
Phone (619) 428-1330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110722000213 CA Practitioner - Family Practice 0042488876 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1136 D Ave
National City, CA 91950-3412
Phone (619) 662-4100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A112597CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centro de Salud de la Comunidad de San Ysidro, Inc. Current Accepting new patients
Centro de Salud de la Comunidad de San Ysidro Inc CurrentSince Jun 30, 2011 Accepting new patients
Centro de Salud de la Comunidad de San Ysidro, Inc. CurrentSince Jun 30, 2011 Accepting new patients
Centro de Salud de la Comunidad de San Ysidro, Inc. Past Accepting new patients
Sharp Memorial Hospital Past Accepting new patients
Sharp Coronado Hospital and Healthcare Center Past Accepting new patients
Sharp Memorial Hospital Past Accepting new patients
Scripps Health Past Accepting new patients
Grossmont Hospital Corporation Past Accepting new patients
Sharp Chula Vista Medical Center Past Accepting new patients
Regents of the University of California Past Accepting new patients
Scripps Health Past Accepting new patients

Locations

1637 Third Ave
Ste B
Chula Vista, CA 91911
Phone (619) 425-1780

865 Third Ave
Ste 133
Chula Vista, CA 91911
Phone (619) 428-1330

1136 D Ave
National City, CA 91950
Phone (619) 336-2300

4004 Beyer Blvd
San Ysidro, CA 92173
Phone (619) 428-1330

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: mdillon18530@syhealth.direct-ci.com

Organizations & group practices 12

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.

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": "1216252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317772800000",
    "number": "1629232715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4004 BEYER BLVD",
            "city": "SAN YSIDRO",
            "state": "CA",
            "postal_code": "921732007",
            "telephone_number": "619-428-1330",
            "fax_number": "619-428-7952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1136 D AVE",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919503412",
            "telephone_number": "619-336-2300",
            "fax_number": "619-336-2323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLON",
        "first_name": "MAYRA",
        "middle_name": "MENDOZA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-17",
        "last_updated": "2011-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A112597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in National City, CA

Sources for this page

Verify at the official NPI Registry.