Jamil Bawerjan Alkhaddo, MD

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

C186416 Issued in CA

Practice address

6185 Paseo del Norte Ste 100
Carlsbad, CA 92011-1152

Phone

(760) 940-7000

Fax

(760) 940-0042

NPI assigned

Oct 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Electronic endpoints 1

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

Specialty

EndocrinologyAlso: Internal Medicine

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tri-City Primary Care Medical Group IncGroup PAC ID 3870810823, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tri-City Medical Center Hospital, Oceanside, CA, CCN 050128

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/6f6fa04d-6294-46cb-a755-92fcf4395ad8/

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.

• Tri-City Primary Care Medical Group, Inc

  • Adult Medicine Physician
  • Vista, CA
  • NPI 1518364165

  Endocrinology, Diabetes & Metabolism

  Medicare reassignment Care Compare group NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • San Diego, CA
  • NPI 1023425972
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Affinity Medical Group

  • Case Manager/Care Coordinator
  • Foster City, CA
  • NPI 1689708042
  NPD (past)
• Tri-City Hospital

  • General Acute Care Hospital
  • Oceanside, CA
  • NPI 1801861190
  NPD (past)
• Canonsburg General Hospital - Spu

  • Ambulatory Surgical Clinic/Center
  • Canonsburg, PA
  • NPI 1710007596
  NPD (past)
• Fairview Health Services

  • General Acute Care Hospital
  • Burnsville, MN
  • NPI 1245217520
  NPD (past)
• Fairview Health Services

  • Hospitalist Physician
  • Edina, MN
  • NPI 1770663031

  Internal Medicine

  NPD (past)
• Hospitalist Medicine Physicians of Franklin County, LTD

  • Internal Medicine Physician
  • Columbus, OH
  • NPI 1326088782
  NPD (past)
• Hospitalist Medicine Physicians of Ohio, Professional Corporation

  • Internal Medicine Physician
  • Columbus, OH
  • NPI 1043572290
  NPD (past)
• Hospitalist Medicine Physicians of Washington County, LLC

  • Internal Medicine Physician
  • Washington, PA
  • NPI 1245553213
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Tri-City Hospital

  • General Acute Care Hospital
  • Oceanside, CA
  • NPI 1801861190
  Care Compare affiliation

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1700966652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1926 VIA CTR STE A",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920816056",
            "telephone_number": "760-940-7000",
            "fax_number": "760-940-0042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6185 PASEO DEL NORTE STE 100",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920111152",
            "telephone_number": "760-940-7000",
            "fax_number": "760-940-0042"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5725 W Las Positas Blvd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Pleasanton",
            "state": "CA",
            "postal_code": "945884016",
            "country_code": "US",
            "telephone_number": "925-416-6767",
            "fax_number": "925-416-6790",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALKHADDO",
        "first_name": "JAMIL",
        "middle_name": "BAWERJAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD432373",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C186416",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "PA",
            "license": "MD432373",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CA",
            "license": "C186416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4647 Zion Ave",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921202507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Farhonda Alizada
• Kiera Corinne Allard Schminke, IBCLC
• Ashley Allen
• Emily-Jane Carolyn Allen
• Jennifer Lee Allen, DACM, L.AC.
• Kimberlee Allen

• Endocrinology, Diabetes & Metabolism Physician in Carlsbad, CA
• Providers in Carlsbad, CA by specialty
• Endocrinology, Diabetes & Metabolism Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.