Individual provider Active NPI

Jorge Emanuelle Silva Enciso, M.D.

  • Advanced Heart Failure and Transplant Cardiology Physician
  • San Diego, CA
National Provider Identifier
1639404031
Registry record updated Oct 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Heart Failure and Transplant Cardiology PhysicianTaxonomy code 207RA0001X
License
A117426 Issued in CA
Practice address
200 W Arbor Dr
San Diego, CA 92103-9000
Phone
(858) 657-8530
NPI assigned
Oct 2, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X A117426 CA
Advanced Heart Failure and Transplant Cardiology Physician 207RA0001X A117426 CA Primary

Addresses

Primary practice location

200 W Arbor Dr
San Diego, CA 92103-9000

Mailing address

PO Box 232410
San Diego, CA 92193-2410

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
I20121011000755 CA Practitioner - Advanced Heart Failure and Transplant CardiologyPractitioner - Cardiovascular Disease (Cardiology) 2163671967 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Advanced Heart Failure and Transplant CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Regents of the University of CaliforniaGroup PAC ID 3577476761, shared by 18 NPIs, 2,047 clinicians

Practice addresses (Care Compare)

200 W Arbor Dr
San Diego, CA 92103-9000
Phone (858) 249-6748

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
117426CAMDSocial Worker
A117426CAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California Cardiovascular Disease CurrentSince Aug 29, 2012 Accepting new patients
Regents of the University of California Family Medicine Current Accepting new patients
Regents of the University of California CurrentSince Aug 29, 2012 Accepting new patients
Regents of the University of California - Ucsd Medical Group CurrentSince May 1, 2016 Accepting new patients
Regents of the University of California Current Accepting new patients
Imperial Valley Family Care Medical Group, Apc CurrentSince Jan 1, 2016 Accepting new patients
Regents of the University of California Current Accepting new patients
Imperial Valley Family Care Medical Group Apc CurrentSince Jan 1, 2016 Accepting new patients
El Centro Regional Medical Center Past Accepting new patients
Regents of the University of California Past Accepting new patients
Regents of the University of California Ucsd Head and Neck Surgery Past Accepting new patients

Locations

125 S 5th St
Brawley, CA 92227
Phone (760) 344-8100

516 W Aten Rd
Ste 2
Imperial, CA 92251
Phone (760) 355-7730

516 W Aten Rd
Ste 1
Imperial, CA 92251
Phone (760) 355-7748

9434 Medical Center Dr
La Jolla, CA 92037
Phone (800) 926-8276

35900 Bob Hope Dr
Ste 257
Rancho Mirage, CA 92270
Phone (760) 321-2500

2131 3rd Ave
Ste 300
San Diego, CA 92101

6655 Alvarado Rd
San Diego, CA 92120
Phone (619) 229-3130

4510 Executive Dr
Ste P7
San Diego, CA 92121

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

Organizations & group practices 11

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 2

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": "1254441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506988800000",
    "number": "1639404031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 232410",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921932410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000",
            "telephone_number": "858-657-8530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SILVA ENCISO",
        "first_name": "JORGE",
        "middle_name": "EMANUELLE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-02",
        "last_updated": "2017-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A117426",
            "primary": false
        },
        {
            "code": "207RA0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Advanced Heart Failure and Transplant Cardiology",
            "state": "CA",
            "license": "A117426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.