Individual provider Active NPI

Clarkson Raymond Crane, MD

  • Pediatric Nephrology Physician
  • San Diego, CA
National Provider Identifier
1689036436
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nephrology PhysicianTaxonomy code 2080P0210X
License
A168738 Issued in CA
Practice address
8110 Birmingham Way BLDG 28
San Diego, CA 92123-2758
Phone
(858) 966-8052
NPI assigned
Mar 22, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A168738 CA
Nephrology Physician 207RN0300X A168738 CA
Pediatrics Physician 208000000X A168738 CA
Pediatric Nephrology Physician 2080P0210X A168738 CA Primary

Addresses

Primary practice location

8110 Birmingham Way BLDG 28
San Diego, CA 92123-2758

Mailing address

3020 Childrens Way # Mc5003
San Diego, CA 92123-4223
Phone (858) 309-6300

Other practice location 1

200 W Arbor Dr
San Diego, CA 92103-9000
Phone (800) 926-8273

Other practice location 2

4510 Executive Dr
San Diego, CA 92121-3021
Phone (800) 926-8273

Other practice location 3

9300 Campus Point Dr
LA Jolla, CA 92037-1300
Phone (800) 926-8273

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
I20240709001457 CA Practitioner - Nephrology 8729344353 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Loma Linda University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3010 Childrens Way
San Diego, CA 92123-4223
Phone (858) 576-1700

3020 Children'S Way
San Diego, CA 92123-4223
Phone (858) 576-1700

4168 Front St
San Diego, CA 92103-2030
Phone (858) 657-7000

4510 Executive Dr
San Diego, CA 92121-3021
Phone (800) 926-8273

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.77 of 100Reported as group
Quality
84.13
Promoting interoperability
100
Improvement activities
40
Cost
73.88

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A168738CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rady Children'S Hospital San Diego CurrentSince Sep 20, 2024 Accepting new patients
Regents of the University of California Current Accepting new patients
Rady Children'S Hospital San Diego Pediatrics CurrentSince Sep 20, 2024 Accepting new patients
Regents of the University of California Nephrology CurrentSince May 26, 2024 Accepting new patients
Regents of the University of California CurrentSince May 26, 2024 Accepting new patients
Marilyn Kaufhold, M.D., a Medical Corporation PastSince Mar 24, 2024 Accepting new patients
Regents of the University of California Ucsd Head and Neck Surgery Past Accepting new patients

Locations

9300 Campus Point Dr
La Jolla, CA 92037
Phone (619) 957-7000

25170 Hancock Ave
Murrieta, CA 92562
Phone (858) 757-3277

3020 Childrens Way
#5003
San Diego, CA 92123
Phone (858) 309-6300

4510 Executive Dr
Ste 201
San Diego, CA 92121
Phone (858) 457-7994

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

4510 Executive Dr
San Diego, CA 92121
Phone (858) 450-5000

4168 Front St
San Diego, CA 92103
Phone (619) 471-0420

3020 Childrens Way
#5137
San Diego, CA 92123

8110 Birmingham Way
Bldg 28
San Diego, CA 92123
Phone (858) 966-4003

3020 Childrens Way
San Diego, CA 92123
Phone (858) 966-5841

Organizations & group practices 7

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 2

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": "1458604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1689036436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 CHILDRENS WAY # MC5003",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234223",
            "telephone_number": "858-309-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8110 BIRMINGHAM WAY BLDG 28",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921232758",
            "telephone_number": "858-966-8052"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 W Arbor Dr",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921039000",
            "country_code": "US",
            "telephone_number": "800-926-8273",
            "fax_number": "888-539-8781",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4510 Executive Dr",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921213021",
            "country_code": "US",
            "telephone_number": "800-926-8273",
            "fax_number": "888-539-8781",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9300 Campus Point Dr",
            "address_purpose": "LOCATION",
            "city": "LA Jolla",
            "state": "CA",
            "postal_code": "920371300",
            "country_code": "US",
            "telephone_number": "800-926-8273",
            "fax_number": "888-539-8781",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRANE",
        "first_name": "CLARKSON",
        "middle_name": "RAYMOND",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-22",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A168738",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A168738",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A168738",
            "primary": false
        },
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "CA",
            "license": "A168738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.