Coastal Skin and Eye Institute, Inc.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

A107312 Issued in CA

Legal business name

COASTAL SKIN AND EYE INSTITUTE, INC.

Practice address

5550 Carmel Mountain Road
Suite 206
San Diego, CA 92130

Phone

(858) 943-2540

NPI assigned

Sep 2, 2016

Organization subpart

No

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

Authorized official

Name

Christopher V Crosby, M.D.NPI 1497931380

Title

President

Phone

(858) 943-2540

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Coastal Skin and Eye Institute, Inc.

  • Ophthalmology Physician
  • Encinitas, CA
  • NPI 1083273684
  NPPES parent name
• Grossmont Dermatology Medical Clinic

  • Procedural Dermatology Physician
  • La Mesa, CA
  • NPI 1194838441
  NPPES parent name

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Christopher V Crosby, M.D., PH.D.

  • MOHS-Micrographic Surgery Physician
  • La Mesa, CA
  • NPI 1497931380

  Dermatology

  Medicare reassignment NPD Authorized official
• Connor Marcus Caldwell, OD

  • Optometrist
  • San Diego, CA
  • NPI 1730726902
  Medicare reassignment NPD
• Michelle Crosby, M.D., PH.D.

  • Ophthalmology Physician
  • Encinitas, CA
  • NPI 1558549303
  Medicare reassignment NPD
• Steven Emmet, M.D.

  • Dermatology Physician
  • Solana Beach, CA
  • NPI 1043391246
  Medicare reassignment NPD
• Maki C. Goskowicz

  • Dermatology Physician
  • La Mesa, CA
  • NPI 1821096942
  Medicare reassignment NPD
• Swati Kannan, M.D.

  • Dermatology Physician
  • San Diego, CA
  • NPI 1508155227
  Medicare reassignment NPD
• Derek Walter Nickerson, M.D.

  • MOHS-Micrographic Surgery Physician
  • San Diego, CA
  • NPI 1265895619

  Dermatology

  Medicare reassignment NPD
• Neeta Varshney, M.D.

  • Ophthalmology Physician
  • Poway, CA
  • NPI 1689806606
  Medicare reassignment NPD
• Paul F Ware, MD

  • Ophthalmology Physician
  • San Diego, CA
  • NPI 1366760464
  Medicare reassignment NPD
• Kira Ann Tellache, PHYSICIAN ASSISTANT

  • Physician Assistant
  • La Mesa, CA
  • NPI 1104441021
  Medicare reassignment

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

{
    "created_epoch": "1472774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476403200000",
    "number": "1790232015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5550 CARMEL MOUNTAIN ROAD",
            "address_2": "SUITE 206",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92130",
            "telephone_number": "858-943-2540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5550 CARMEL MOUNTAIN ROAD",
            "address_2": "SUITE 206",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92130",
            "telephone_number": "858-943-2540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL SKIN AND EYE INSTITUTE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-02",
        "last_updated": "2016-10-14",
        "status": "A",
        "authorized_official_last_name": "CROSBY",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "858-943-2540",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A107312",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Coastal Medical Group Inc
• Coastal Pain & Spinal Diagnostics Medical Group, Inc.
• Coastal Psychiatric Medical Associates, Inc.
• Coastal Regenerative Orthopedics & Wellness Center Inc.
• Coastal Serenity Psychiatry a Professional Nursing Corporation
• Coastal Sleep Solutions San Diego, Inc.
• Coastal Speech Therapy Inc
• Coastal Sports and Wellness, Inc
• Coastal Therapy Associates, Inc.
• Coastal Wellness Services, LLC

• Dermatology Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.