NPIMap

Organization Active NPI

Enlightened Healthcare Alliance Medical Corporation

Doing business as Good Medicine

  • Internal Medicine Physician
  • Encinitas, CA
National Provider Identifier
1710458245
Registry record updated Apr 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ENLIGHTENED HEALTHCARE ALLIANCE MEDICAL CORPORATION
Doing business as
Good Medicine
Good Medicine, Inc.
Practice address
662 Encinitas Blvd Ste 220
Encinitas, CA 92024-6791
Phone
(833) 446-6363
NPI assigned
Dec 10, 2018
Last updated
Apr 15, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2020

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

Authorized official

Name
Alexie Khanh Nguyen, MDNPI 1659367613
Title
President
Phone
(833) 466-6363

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Hospice and Palliative Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0002X

Addresses

Primary practice location

662 Encinitas Blvd Ste 220
Encinitas, CA 92024-6791

Mailing address

PO Box 231366
Encinitas, CA 92023-1366

Other practice location 1

320 Santa Fe Dr Ste 107-B
Encinitas, CA 92024-5138
Phone (760) 203-5545

Other identifiers 1

IdentifierTypeStateIssuer
1710458245MedicaidCA

Other names 2

  • Good Medicine Doing business as
  • Good Medicine, Inc. Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190313000240 CA Part B Supplier - Clinic/Group Practice 6608115043 Receives reassigned benefits from 70 practitioners
Practice locations: Encinitas, CA; La Jolla, CA

National Provider Directory

National Provider Directory

Locations

320 Santa Fe Dr
#107C
Encinitas, CA 92024

Practitioners & affiliated clinicians

Practitioners 99

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 99

NPI Registry JSON

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

{
    "created_epoch": "1544400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586908800000",
    "number": "1710458245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 231366",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920231366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "662 ENCINITAS BLVD STE 220",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920246791",
            "telephone_number": "833-446-6363"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "320 Santa Fe Dr Ste 107-B",
            "address_purpose": "LOCATION",
            "city": "Encinitas",
            "state": "CA",
            "postal_code": "920245138",
            "country_code": "US",
            "telephone_number": "760-203-5545",
            "fax_number": "760-633-7879",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ENLIGHTENED HEALTHCARE ALLIANCE MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-10",
        "last_updated": "2020-04-15",
        "certification_date": "2020-04-15",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "ALEXIE",
        "authorized_official_middle_name": "KHANH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "833-466-6363",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1710458245",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Good Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Good Medicine, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Encinitas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.