Individual provider Active NPI

Elaine Eng

  • Family Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1669713954
Registry record updated Jul 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95001024 Issued in CA
Practice address
1313 Park Blvd # a-180
San Diego, CA 92101-4712
Phone
(619) 388-3450
NPI assigned
Mar 11, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 338520 NY
Family Nurse Practitioner 363LF0000X 95001024 CA Primary

Addresses

Primary practice location

1313 Park Blvd # a-180
San Diego, CA 92101-4712

Mailing address

1313 Park Blvd # a-180
San Diego, CA 92101-4712
Phone (619) 388-3450

Other practice location 1

501 Washington St Ste 600
San Diego, CA 92103-2239
Phone (619) 278-3300

Other practice location 2

10440 Black Mountain Rd # 103
San Diego, CA 92126-2910
Phone (858) 536-7881

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
338520NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Current Accepting new patients

Locations

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

10790 Rancho Bernardo Rd
San Diego, CA 92127
Phone (858) 554-2626

Interoperability endpoints

  • Direct secure messaging: eeng378640@scrippshlth.medalliesdirect.net

Organizations & group practices 1

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": "1362960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690675200000",
    "number": "1669713954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 PARK BLVD # A-180",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921014712",
            "telephone_number": "619-388-3450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 PARK BLVD # A-180",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921014712",
            "telephone_number": "619-388-3450"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 Washington St Ste 600",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921032239",
            "country_code": "US",
            "telephone_number": "619-278-3300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10440 Black Mountain Rd # 103",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921262910",
            "country_code": "US",
            "telephone_number": "858-536-7881",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ENG",
        "first_name": "ELAINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-11",
        "last_updated": "2023-07-30",
        "certification_date": "2023-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "338520",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95001024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.