Individual provider Active NPI

Teresa Dudarewicz, M.D.

  • Family Medicine Physician
  • La Jolla, CA
National Provider Identifier
1679634406
Registry record updated Mar 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A65431 Issued in CA
Practice address
7300 Girard Ave
La Jolla, CA 92037-5138
Phone
(858) 729-0034
Fax
(858) 729-0319
NPI assigned
Dec 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A65431 CA Primary

Addresses

Primary practice location

7300 Girard Ave
La Jolla, CA 92037-5138

Mailing address

7300 Girard Ave
La Jolla, CA 92037-5138
Phone (858) 729-0034

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
I20040209001233 CA Practitioner - Family Practice 6901799527 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Monica Perlman MD IncGroup PAC ID 8820035884, 357 clinicians

Practice addresses (Care Compare)

11440 W Bernardo CT
Suite 300
San Diego, CA 92127-1644
Phone (858) 442-0753

9909 Mira Mesa Blvd
Suite 110
San Diego, CA 92131-1060
Phone (858) 554-1212

Merit-based Incentive Payment System (MIPS)

Final score
92.17 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
73.9

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Monica Perlman MD Inc. Family Medicine CurrentSince Apr 7, 2022 Accepting new patients
UC San Diego Health - Rancho Family Medical Group Past Accepting new patients
Indiana University Health Ball Memorial Hospital, Inc. Past Accepting new patients
Regents of the University of California Past Accepting new patients
Mobile Medical Group Past Accepting new patients

Locations

9850 Genesee Ave
Ste 320
La Jolla, CA 92037
Phone (858) 864-9800

3737 Moraga Ave
Ste B103
San Diego, CA 92117
Phone (858) 799-0855

9909 Mira Mesa Blvd
Ste 110
San Diego, CA 92131

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522022400000",
    "number": "1679634406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7300 GIRARD AVE",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920375138",
            "telephone_number": "858-729-0034",
            "fax_number": "858-729-0319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 GIRARD AVE",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920375138",
            "telephone_number": "858-729-0034",
            "fax_number": "858-729-0319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDAREWICZ",
        "first_name": "TERESA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2018-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A65431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

Verify at the official NPI Registry.