Individual provider Active NPI

Julie Akiko Gladsjo, MD

  • Dermatology Physician
  • San Diego, CA
National Provider Identifier
1629234380
Registry record updated Oct 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
A98641 Issued in CA
Practice address
6195 Lusk Blvd Ste 250
San Diego, CA 92121-3715
Phone
(858) 859-1188
NPI assigned
Aug 1, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X A98641 CA Primary

Addresses

Primary practice location

6195 Lusk Blvd Ste 250
San Diego, CA 92121-3715

Mailing address

1318 Calle Scott
Encinitas, CA 92024-5531
Phone (858) 344-4349

Other practice location 1

760 E Solana Cir
Solana Beach, CA 92075-2356
Phone (858) 344-4349

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090715000734 CA Practitioner - DermatologyPractitioner - Micrographic Dermatologic Surgery (MDS) 5193877587 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
DermatologyAlso: Micrographic Dermatologic Surgery (MDS)
Education
University of California, San Diego School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bernardo Dermatology Medical Group IncGroup PAC ID 6507802964, 8 clinicians
J Robert West MD IncGroup PAC ID 8729990973, 141 clinicians

Practice addresses (Care Compare)

15525 Pomerado Rd
Suite A2
Poway, CA 92064-2425
Phone (858) 451-3311

400 Newport Ctr Dr
Suite 702
Newport Beach, CA 92660-7669
Phone (949) 644-0101

477 N El Camino Real
Suite D308
Encinitas, CA 92024-1370
Phone (760) 436-2300

Merit-based Incentive Payment System (MIPS)

Final score
85.17 of 100Reported as group
Quality
74.51
Promoting interoperability
92
Improvement activities
40
Cost
82.72

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision48
Removal of skin lesions342
Removal of skin cancer344
Removal or shaving of skin growth1-10
Skin biopsy106

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A98641CAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Leur Medicine Inc Dermatology CurrentSince Jun 1, 2016 Accepting new patients
Bernardo Dermatology Medical Group Inc Dermatology CurrentSince Mar 1, 2014 Accepting new patients
J Robert West, M.D., Inc Dermatology CurrentSince Jun 1, 2016 Accepting new patients
Csi Medical Group Dermatology PastSince Nov 29, 2018 Accepting new patients
Stacy D. Tompkins, M.D., Inc. Dermatology Past Accepting new patients
Yuma Regional Medical Center Past Accepting new patients

Locations

1030 W 24th St
Ste C-2
Yuma, AZ 85364
Phone (928) 247-6825

6010 Hidden Valley Rd
Ste 120
Carlsbad, CA 92011
Phone (760) 448-4484

12865 Pointe del Mar Way
Ste 160
Del Mar, CA 92014
Phone (858) 350-7546

477 N El Camino Real
Ste D308
Encinitas, CA 92024
Phone (760) 436-2300

7301 Girard Ave
Ste 300
La Jolla, CA 92037
Phone (858) 454-4300

400 Newport Center Dr
Ste 702
Newport Beach, CA 92660
Phone (949) 644-0101

359 San Miguel Dr
Ste 300
Newport Beach, CA 92660
Phone (949) 200-8222

15525 Pomerado Rd
Ste A2
Poway, CA 92064
Phone (858) 451-3311

4060 4th Ave
Ste 415
San Diego, CA 92103
Phone (619) 298-9809

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1217548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666828800000",
    "number": "1629234380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1318 CALLE SCOTT",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920245531",
            "telephone_number": "858-344-4349",
            "fax_number": "619-437-1912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6195 LUSK BLVD STE 250",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921213715",
            "telephone_number": "858-859-1188"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "760 E Solana Cir",
            "address_purpose": "LOCATION",
            "city": "Solana Beach",
            "state": "CA",
            "postal_code": "920752356",
            "country_code": "US",
            "telephone_number": "858-344-4349",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLADSJO",
        "first_name": "JULIE",
        "middle_name": "AKIKO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-01",
        "last_updated": "2022-10-27",
        "certification_date": "2022-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A98641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.