Individual provider Active NPI

Scott A. Godfrey, DO

  • Hematology & Oncology Physician
  • San Diego, CA
National Provider Identifier
1659464089
Registry record updated Nov 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
20A5999 Issued in CA
Practice address
4647 Zion Ave
San Diego, CA 92120-2507
Phone
(619) 528-5000
NPI assigned
Sep 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 20A5999 CA Primary

Addresses

Primary practice location

4647 Zion Ave
San Diego, CA 92120-2507

Mailing address

4647 Zion Ave
San Diego, CA 92120-2507
Phone (619) 528-5000

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20081027000788 CA Practitioner - Internal MedicinePractitioner - Hematology/Oncology 9638237167 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hematology/Oncology
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sansum ClinicGroup PAC ID 3678471976, 320 clinicians
Sharp Rees-Stealy Medical Group IncGroup PAC ID 8628972759, 872 clinicians

Practice addresses (Care Compare)

540 W Pueblo St
Santsa Barbara, CA 93105-4310
Phone (805) 681-1761

5525 Grossmont Ctr Dr
La Mesa, CA 91942-3009
Phone (858) 499-2600

Hospital & facility affiliations

  • Grossmont Hospital Hospital, La Mesa, CA, CCN 050026
  • Sharp Memorial Hospital Hospital, San Diego, CA, CCN 050100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A5999CAMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Jan 3, 2022 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Aug 17, 2009 Accepting new patients
Sansum Clinic CurrentSince Sep 19, 2022 Accepting new patients
Sansum Clinic CurrentSince Sep 19, 2022 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Jan 3, 2022 Accepting new patients
Southern California Permanente Medical Group CurrentSince Aug 17, 2009 Accepting new patients
Sansum Clinic Current Accepting new patients
Santa Barbara Cottage Hospital Past Accepting new patients
Sharp Rees-Stealy Medical Center Past Accepting new patients

Locations

5475 E La Palma Ave
Anaheim, CA 92807
Phone (714) 279-6088

5525 Grossmont Center Dr
La Mesa, CA 91942
Phone (619) 644-6600

13652 Cantara St
Panorama City, CA 91402
Phone (818) 375-2417

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

4647 Zion Ave
San Diego, CA 92120
Phone (619) 528-3038

8010 Frost St
Fl 2
San Diego, CA 92123
Phone (800) 827-4277

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

540 W Pueblo St
Santa Barbara, CA 93105
Phone (805) 563-5800

215 Pesetas Ln
Santa Barbara, CA 93110
Phone (805) 681-1765

Organizations & group practices 10

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 3

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": "1159574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1659464089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4647 ZION AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921202507",
            "telephone_number": "619-528-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4647 ZION AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921202507",
            "telephone_number": "619-528-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODFREY",
        "first_name": "SCOTT",
        "middle_name": "A.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-30",
        "last_updated": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "20A5999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4647 Zion Ave",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921202507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.