Individual provider Active NPI

Bruce Covner, M.D.

  • Internal Medicine Physician
  • La Jolla, CA
National Provider Identifier
1720072192
Registry record updated May 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G45620 Issued in CA
Practice address
9850 Genesee Ave
Suite 355
La Jolla, CA 92037-1224
Phone
(858) 202-0011
Fax
(858) 202-0055
NPI assigned
Aug 31, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G45620 CA Primary

Addresses

Primary practice location

9850 Genesee Ave
Suite 355
La Jolla, CA 92037-1224

Mailing address

9850 Genesee Ave
Suite 355
La Jolla, CA 92037-1224
Phone (858) 202-0011

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
I20071113000236 CA Practitioner - Internal Medicine 1254429087 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1980
Medicare assignment
May accept Medicare assignment
Group practices
Ximed Hospitalists, Inc.Group PAC ID 7214939222, 35 clinicians

Practice addresses (Care Compare)

9850 Genesee Ave
Suite 355
La Jolla, CA 92037-1224
Phone (858) 202-0111

9850 Genesee Ave
Suite 355
La Jolla, CA 92037-1227

9888 Genesee Ave
La Jolla, CA 92037-1205
Phone (858) 457-4123

Hospital & facility affiliations

  • Seaport Scripps Home Health Home health agency, San Diego, CA, CCN 057602
  • Scripps Memorial Hospital la Jolla Hospital, La Jolla, CA, CCN 050324

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G45620CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prima Primary Medical Association, Inc Internal Medicine CurrentSince Sep 1, 1992 Accepting new patients
Ximed Hospitalists, Inc. CurrentSince Oct 1, 2007 Accepting new patients
Scripps Health Current Accepting new patients

Locations

9850 Genesee Ave
Ste 355
La Jolla, CA 92037
Phone (858) 202-0011

9850 Genesee Ave
Ste 900
La Jolla, CA 92037
Phone (858) 452-1279

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: bcovner28106@scrippshlth.medalliesdirect.net

Organizations & group practices 3

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": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274227200000",
    "number": "1720072192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9850 GENESEE AVE",
            "address_2": "SUITE 355",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371224",
            "telephone_number": "858-202-0011",
            "fax_number": "858-202-0055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9850 GENESEE AVE",
            "address_2": "SUITE 355",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371224",
            "telephone_number": "858-202-0011",
            "fax_number": "858-202-0055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COVNER",
        "first_name": "BRUCE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2010-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G45620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

Verify at the official NPI Registry.