Individual provider Active NPI

Jens Thiele, M.D.

  • Dermatology Physician
  • Oceanside, CA
National Provider Identifier
1659562650
Registry record updated Jan 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
A103862 Issued in CA
Practice address
3629 Vista Way
Oceanside, CA 92056-4522
Phone
(760) 757-7646
NPI assigned
Aug 5, 2007
Last updated
Jan 19, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X A103862 CA Primary
MOHS-Micrographic Surgery Physician 207ND0101X A103862 CA

Addresses

Primary practice location

3629 Vista Way
Oceanside, CA 92056-4522

Mailing address

3629 Vista Way
Oceanside, CA 92056-4522
Phone (760) 757-7546

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
I20090714000611 CA Practitioner - Dermatology 0840361788 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Specialists IncGroup PAC ID 2769380989, 14 clinicians

Practice addresses (Care Compare)

25495 Medical Ctr Dr
Suite 200
Murrieta, CA 92562-4903
Phone (951) 304-7546

Merit-based Incentive Payment System (MIPS)

Final score
93.18 of 100Reported as group
Quality
86.36
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision686
Removal of tissue65
Removal of skin lesions1884
Removal of skin cancer1190
Removal or shaving of skin growth1-10
Skin biopsy489

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A103862CAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Specialists, Inc Dermatology PastSince Aug 1, 2009 Accepting new patients
Universal Health Services of Rancho Springs Inc Past Accepting new patients
Dermatology Specialists Inc Dermatology Past Accepting new patients
Skin Diagnostics Group, PC Past Accepting new patients
Affinity Hospital LLC Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674086400000",
    "number": "1659562650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3629 VISTA WAY",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920564522",
            "telephone_number": "760-757-7546",
            "fax_number": "760-728-9138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3629 VISTA WAY",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920564522",
            "telephone_number": "760-757-7646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIELE",
        "first_name": "JENS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-05",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A103862",
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "CA",
            "license": "A103862",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, CA

Sources for this page

Verify at the official NPI Registry.