Ebtissam H Korkis, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A89767 Issued in CA

Practice address

1530 Jamacha Road
Unit E Unit F
El Cajon, CA 92019

Phone

(619) 441-9200

NPI assigned

Dec 14, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ebtisam H Georges Other name

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

Specialty

Family Practice

Education

Other, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• Grossmont Hospital Hospital, La Mesa, CA, CCN 050026

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Ebtissam H Korkis MD Inc

  • Family Medicine Physician
  • El Cajon, CA
  • NPI 1144732595
  Medicare reassignment Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Grossmont Hospital Corporation

  dba Sharp Grossmont Hospital

  • General Acute Care Hospital
  • La Mesa, CA
  • NPI 1528041811
  Care Compare affiliation

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214524800000",
    "number": "1780746263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 JAMACHA ROAD",
            "address_2": "UNIT E",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "92019",
            "telephone_number": "619-441-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 JAMACHA ROAD",
            "address_2": "UNIT E UNIT F",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "92019",
            "telephone_number": "619-441-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORKIS",
        "first_name": "EBTISSAM",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-14",
        "last_updated": "2008-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A89767",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A897670",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EBTISAM",
            "last_name": "GEORGES",
            "middle_name": "H",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Danielle Kohfeldt
• Frank Stephen Kohl
• Komaki Enterprises, Inc (Pillco Pharmacy)
• Stephenie Konx, RN
• Yosuf Korel, D.D.S.
• Vivian K Korkis
• Charlett Marie Korling
• John J Kownacki, MD
• Olivia Kozarev, LCSW
• Marc Ian Kraidman

• Family Medicine Physician in El Cajon, CA
• Providers in El Cajon, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.