Individual provider Active NPI

Raquel L Rissman, M.D.

  • Pediatrics Physician
  • San Diego, CA
National Provider Identifier
1700998846
Registry record updated Feb 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A82394 Issued in CA
Practice address
550 Washington St
Ste 300
San Diego, CA 92103-2227
Phone
(619) 297-5437
Fax
(619) 243-0722
NPI assigned
Aug 31, 2006
Last updated
Feb 23, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A82394 CA
Pediatrics Physician 208000000X A82394 CA Primary

Addresses

Primary practice location

550 Washington St
Ste 300
San Diego, CA 92103-2227

Mailing address

550 Washington St
Ste 300
San Diego, CA 92103-2227
Phone (619) 297-5437

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
I20070724000782 CA Practitioner - Pediatric Medicine 0941301691 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A82394CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince May 24, 2023 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc Pediatrics CurrentSince May 24, 2023 Accepting new patients
Scripps Health Current Accepting new patients
Sharp Memorial Hospital Past Accepting new patients
Pediatric Primary Care Associated Medical Group Past Accepting new patients
Sharp Rees-Stealy Medical Center Past Accepting new patients
Scripps Health Past Accepting new patients
Rady Children's Hospital San Diego Past Accepting new patients
Childrens Healthcare Medical Associates Pediatrics Past Accepting new patients

Locations

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

Interoperability endpoints

  • Direct secure messaging: rrissman119573@sharphealthcare.direct-ci.com
  • Direct secure messaging: rrissman81521@scrippshlth.medalliesdirect.net

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329955200000",
    "number": "1700998846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 WASHINGTON ST",
            "address_2": "STE 300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032227",
            "telephone_number": "619-297-5437",
            "fax_number": "619-243-0722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 WASHINGTON ST",
            "address_2": "STE 300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032227",
            "telephone_number": "619-297-5437",
            "fax_number": "619-243-0722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RISSMAN",
        "first_name": "RAQUEL",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2012-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A82394",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A82394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.