Individual provider Active NPI

Marisol Balistreri, NP

  • Family Nurse Practitioner
  • El Cajon, CA
National Provider Identifier
1649608324
Registry record updated Nov 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
23462 Issued in CA
Practice address
1201 S Orange Ave
El Cajon, CA 92020-7521
Phone
(619) 441-1918
Fax
(619) 441-7416
NPI assigned
Oct 16, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2017

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 23462 CA Primary

Addresses

Primary practice location

1201 S Orange Ave
El Cajon, CA 92020-7521

Mailing address

332 S Michigan Ave Ste 1100
Chicago, IL 60604-4416
Phone (888) 660-4425

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
I20140130000267 CA Practitioner - Nurse Practitioner 1456580125 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23462CAMDPhysical Rehabilitation Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Current Accepting new patients
Scripps Health CurrentSince Jan 1, 2018 Accepting new patients
Scripps Health CurrentSince Jan 1, 2018 Accepting new patients

Locations

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

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

Interoperability endpoints

  • Direct secure messaging: mbalistreri33393@scrippshlth.medalliesdirect.net

Organizations & group practices 3

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": "1381881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511481600000",
    "number": "1649608324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332 S MICHIGAN AVE STE 1100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606044416",
            "telephone_number": "888-660-4425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 S ORANGE AVE",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920207521",
            "telephone_number": "619-441-1918",
            "fax_number": "619-441-7416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALISTRERI",
        "first_name": "MARISOL",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-16",
        "last_updated": "2017-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "23462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Cajon, CA

Sources for this page

Verify at the official NPI Registry.