Individual provider Active NPI

Marie Melanie Deetjen, DNP-FNP

  • Family Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1639686496
Registry record updated Jan 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95005633 Issued in CA
Practice address
501 Washington St
San Diego, CA 92103-2231
Phone
(619) 278-3300
NPI assigned
Jan 3, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95005633 CA Primary

Addresses

Primary practice location

501 Washington St
San Diego, CA 92103-2231

Mailing address

10790 Rancho Bernardo Rd # 4S-205
San Diego, CA 92127-5705
Phone (619) 278-3300

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
I20180206000993 CA Practitioner - Nurse Practitioner 9436419728 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Scripps HealthGroup PAC ID 9234033853, 1,450 clinicians

Practice addresses (Care Compare)

501 Washington St
San Diego, CA 92103-2239
Phone (619) 278-3300

9888 Genesee Ave
La Jolla, CA 92037-1205
Phone (858) 626-4123

9896 Genesee Ave
La Jolla, CA 92037-1205
Phone (858) 626-4123

9898 Genesee Ave
La Jolla, CA 92037-1205
Phone (858) 455-9100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Current Accepting new patients
Scripps Health Current Accepting new patients
Scripps Health CurrentSince Feb 5, 2018 Accepting new patients
Scripps Health Current Accepting new patients
Scripps Health CurrentSince Feb 5, 2018 Accepting new patients
Scripps Clinic Medical Group Past Accepting new patients
Scripps Health Past Accepting new patients

Locations

2176 Salk Ave
Fl 1
Carlsbad, CA 92008

971 Lane Ave
Fl 2
Chula Vista, CA 91914

477 N El Camino Real
Ste B303
Encinitas, CA 92024
Phone (760) 479-3900

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

File 54433
Los Angeles, CA 90074
Phone (858) 784-5645

2205 Vista Way
Ste 130
Oceanside, CA 92054
Phone (760) 704-5911

501 Washington St
San Diego, CA 92103
Phone (619) 278-3300

10790 Rancho Bernardo Rd
#4S205
San Diego, CA 92127
Phone (858) 605-7171

111 Campus Way
Ste 301
San Marcos, CA 92078
Phone (760) 745-5700

380 Stevens Ave
Ste 100
Solana Beach, CA 92075
Phone (858) 554-9800

130 Cedar Rd
Ste 102
Vista, CA 92083

Interoperability endpoints

  • Direct secure messaging: mdeetjen18783@scrippshlth.medalliesdirect.net

Organizations & group practices 7

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": "1514937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514937600000",
    "number": "1639686496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10790 RANCHO BERNARDO RD # 4S-205",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275705",
            "telephone_number": "619-278-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 WASHINGTON ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032231",
            "telephone_number": "619-278-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEETJEN",
        "first_name": "MARIE",
        "middle_name": "MELANIE",
        "name_prefix": "Mrs.",
        "credential": "DNP-FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-03",
        "last_updated": "2018-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95005633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.