Individual provider Active NPI

Michael L Tobin, M.D.

  • Diagnostic Radiology Physician
  • San Diego, CA
National Provider Identifier
1730132150
Registry record updated Apr 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A45908 Issued in CA
Practice address
150 W Washington St
San Diego, CA 92103-2005
Phone
(619) 295-9729
NPI assigned
May 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X A45908 CA Primary

Addresses

Primary practice location

150 W Washington St
San Diego, CA 92103-2005

Mailing address

150 W Washington St
San Diego, CA 92103-2005

Other identifiers 1

IdentifierTypeStateIssuer
00A459080MedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address imaging_healthcare_specialists@direct.sdhealthconnect.org

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
I20031118000823 CA Practitioner - Diagnostic Radiology 5092629576 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A45908CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Current Accepting new patients
IHS Radiology Medical Group, Inc. Diagnostic Radiology CurrentSince Apr 24, 2015 Accepting new patients
Physicians Radiology Medical Group, Inc. Diagnostic Radiology Past Accepting new patients

Locations

333 H St
Ste 1095
Chula Vista, CA 91910
Phone (619) 409-9119

477 N El Camino Real
Ste A102
Encinitas, CA 92024
Phone (760) 452-7150

4150 Regents Park Row
Ste 195
La Jolla, CA 92037
Phone (858) 622-6464

25150 Hancock Ave
Ste 105
Murrieta, CA 92562
Phone (951) 412-0228

2427 Transportation Ave
National City, CA 91950

3601 Vista Way
Ste 101
Oceanside, CA 92056
Phone (760) 631-7505

1801 W Olympic Blvd
#1313
Pasadena, CA 91199

1801 W Olympic Blvd
#1317
Pasadena, CA 91199

1801 W Olympic Blvd
#1315
Pasadena, CA 91199

1801 W Olympic Blvd
Pasadena, CA 91199

12620 Monte Vista Rd
Ste A
Poway, CA 92064
Phone (858) 487-9729

150 W Washington St
San Diego, CA 92103
Phone (619) 295-9729

6386 Alvarado Ct
Ste 121
San Diego, CA 92120
Phone (619) 229-2299

3939 Ruffin Rd
Ste 102
San Diego, CA 92123
Phone (858) 200-3300

4077 5th Ave
San Diego, CA 92103
Phone (619) 260-7245

Interoperability endpoints

  • Direct secure messaging: mtobin36327@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.

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618185600000",
    "number": "1730132150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 W WASHINGTON ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 W WASHINGTON ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032005",
            "telephone_number": "619-295-9729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOBIN",
        "first_name": "MICHAEL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A45908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A459080",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "imaging_healthcare_specialists@direct.sdhealthconnect.org",
            "affiliation": "N",
            "address_1": "150 W Washington St",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921032005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.