Individual provider Active NPI

Kevin Matthew Delgadillo, PA-C

  • Medical Physician Assistant
  • La Mesa, CA
National Provider Identifier
1770750978
Registry record updated May 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA19726 Issued in CA
Practice address
7862 El Cajon Blvd
La Mesa, CA 91942-6712
Phone
(619) 644-6452
Fax
(619) 466-7528
NPI assigned
May 15, 2008
Last updated
May 5, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA19726 CA Primary

Addresses

Primary practice location

7862 El Cajon Blvd
La Mesa, CA 91942-6712

Mailing address

7862 El Cajon Blvd
La Mesa, CA 91942-6712
Phone (619) 644-6452

Other identifiers 1

IdentifierTypeStateIssuer
1861593063MedicaidCA

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100722000494 CA Practitioner - Physician Assistant 4284766585 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sharp Rees-Stealy Medical Group IncGroup PAC ID 8628972759, 872 clinicians

Practice addresses (Care Compare)

10670 Wexford St
San Diego, CA 92131-3940
Phone (858) 621-4002

8975 Balboa Ave
San Diego, CA 92123-1507
Phone (858) 499-2600

Merit-based Incentive Payment System (MIPS)

Final score
88.67 of 100Reported as group
Quality
81.04
Promoting interoperability
99
Improvement activities
40
Cost
82.04

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
19726CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Sharp Memorial Hospital Past Accepting new patients
Sharp Rees-Stealy Medical Center Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kdelgadillo33102@sharphealthcare.direct-ci.com

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, 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": "1210809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493942400000",
    "number": "1770750978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7862 EL CAJON BLVD",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919426712",
            "telephone_number": "619-644-6452",
            "fax_number": "619-466-7528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7862 EL CAJON BLVD",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919426712",
            "telephone_number": "619-644-6452",
            "fax_number": "619-466-7528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELGADILLO",
        "first_name": "KEVIN",
        "middle_name": "MATTHEW",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-15",
        "last_updated": "2017-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA19726",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1861593063",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mesa, CA

Sources for this page

Verify at the official NPI Registry.