Organization Active NPI

Heart Health Center of San Diego, a Medical Corporation

  • Cardiovascular Disease Physician
  • National City, CA
National Provider Identifier
1629520986
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
C55986 Issued in CA
Legal business name
HEART HEALTH CENTER OF SAN DIEGO, A MEDICAL CORPORATION
Practice address
1415 E 8TH St Ste 8
National City, CA 91950-2663
Phone
(718) 704-4533
Fax
(619) 434-4315
NPI assigned
Nov 2, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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

Authorized official

Name
Dr. Mariusz Witold Wysoczanski, M.D.NPI 1659535656
Title
President
Phone
(718) 704-4533

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X C55986 CA Primary

Addresses

Primary practice location

1415 E 8TH St Ste 8
National City, CA 91950-2663

Mailing address

1950 Corte Belize
Chula Vista, CA 91914-4618
Phone (718) 704-4533

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161220001219 CA Part B Supplier - Clinic/Group Practice 7517248172 Receives reassigned benefits from 2 practitioners
Practice locations: Chula Vista, CA; National City, CA

National Provider Directory

National Provider Directory

Locations

1415 E 8th St
Ste 8
National City, CA 91950
Phone (619) 482-0112

1415 E 8th St
National City, CA 91950

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1478044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694390400000",
    "number": "1629520986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 CORTE BELIZE",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919144618",
            "telephone_number": "718-704-4533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 E 8TH ST STE 8",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919502663",
            "telephone_number": "718-704-4533",
            "fax_number": "619-434-4315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEART HEALTH CENTER OF SAN DIEGO, A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-02",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A",
        "authorized_official_last_name": "WYSOCZANSKI",
        "authorized_official_first_name": "MARIUSZ",
        "authorized_official_middle_name": "WITOLD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-704-4533",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "C55986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in National City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.