Individual provider Active NPI

Jadwiga M Alexiewicz, MD

  • Nephrology Physician
  • San Diego, CA
National Provider Identifier
1760487458
Registry record updated Sep 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A64466 Issued in CA
Practice address
7910 Frost St
Ste 220
San Diego, CA 92123-2771
Phone
(858) 637-4700
Fax
(858) 637-4701
NPI assigned
Jun 17, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X A64466 CA Primary

Addresses

Primary practice location

7910 Frost St
Ste 220
San Diego, CA 92123-2771

Mailing address

9610 Granite Ridge Dr
Ste B
San Diego, CA 92123-2684
Phone (858) 810-8000

Other identifiers 1

IdentifierTypeStateIssuer
WA64466AOtherCASO. CALIFORNIA PTAN

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
I20080403000117 CA Practitioner - NephrologyPractitioner - Internal Medicine 1557451366 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
64466CAMDGeneral Practice Dentistry
A64466CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency and Acute Care Medical Corporation CurrentSince Sep 1, 2007 Accepting new patients

Locations

4060 4th Ave
Ste 220
San Diego, CA 92103
Phone (619) 299-2350

7901 Frost St
San Diego, CA 92123
Phone (619) 541-3400

Organizations & group practices 1

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": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442534400000",
    "number": "1760487458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9610 GRANITE RIDGE DR",
            "address_2": "STE B",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921232684",
            "telephone_number": "858-810-8000",
            "fax_number": "858-268-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7910 FROST ST",
            "address_2": "STE 220",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921232771",
            "telephone_number": "858-637-4700",
            "fax_number": "858-637-4701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEXIEWICZ",
        "first_name": "JADWIGA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-17",
        "last_updated": "2015-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A64466",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SO. CALIFORNIA PTAN",
            "identifier": "WA64466A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.