NPIMap

Individual provider Active NPI

Stefan A Willging, MD

  • Internal Medicine Physician
  • San Diego, CA
National Provider Identifier
1679523518
Registry record updated Feb 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A81537 Issued in CA
Practice address
4060 4TH Ave
Suite 505
San Diego, CA 92103
Phone
(619) 298-1311
Fax
(619) 298-0843
NPI assigned
May 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A81537 CA Primary

Addresses

Primary practice location

4060 4TH Ave
Suite 505
San Diego, CA 92103

Mailing address

4060 4TH Ave
Suite 505
San Diego, CA 92103
Phone (619) 298-1311

Other identifiers 1

IdentifierTypeStateIssuer
GR0086930MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041013001463 CA Practitioner - Internal Medicine 1355301334 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hillcrest Internal Medicine a Medical CorporationGroup PAC ID 1850323411, 5 clinicians

Practice addresses (Care Compare)

4060 4TH Ave
Suite 505
San Diego, CA 92103-2121
Phone (619) 298-1318

Hospital & facility affiliations

  • Lorian Health Home health agency, San Diego, CA, CCN 058113
  • Seaport Scripps Home Health Home health agency, San Diego, CA, CCN 057602
  • Silver Tree Home Health Inc Home health agency, San Diego, CA, CCN 559731
  • Scripps Mercy Hospital Hospital, San Diego, CA, CCN 050077
  • Sharp Coronado Hospital and Hlthcr Ctr Hospital, Coronado, CA, CCN 050234
  • Grossmont Hospital Hospital, La Mesa, CA, CCN 050026
  • Scripps Memorial Hospital la Jolla Hospital, La Jolla, CA, CCN 050324
  • Sharp Memorial Hospital Hospital, San Diego, CA, CCN 050100

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A81537CAMDInternal Medicine Physician

Practice roles (3 of 4)

OrganizationSpecialtyStatusNew patients
Scripps Health Current Accepting new patients
Hillcrest Internal Medicine a Medical Corporation Internal Medicine CurrentSince Sep 1, 2005 Accepting new patients
Scripps Health Past Accepting new patients

Locations

4060 4th Ave
Ste 505
San Diego, CA 92103
Phone (619) 298-1318

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: swillging31713@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.

Hospital & facility affiliations 9

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": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424822400000",
    "number": "1679523518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4060 4TH AVE",
            "address_2": "SUITE 505",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92103",
            "telephone_number": "619-298-1311",
            "fax_number": "619-298-0843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4060 4TH AVE",
            "address_2": "SUITE 505",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92103",
            "telephone_number": "619-298-1311",
            "fax_number": "619-298-0843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLGING",
        "first_name": "STEFAN",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2015-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A81537",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0086930",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.