Individual provider Active NPI

Anna Ruth Spain

  • Surgical Physician Assistant
  • La Jolla, CA
National Provider Identifier
1790530152
Registry record updated Apr 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
9850 Genesee Ave Ste 660
La Jolla, CA 92037-1231
Phone
(858) 452-5054
NPI assigned
Apr 19, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X Primary

Addresses

Primary practice location

9850 Genesee Ave Ste 660
La Jolla, CA 92037-1231

Mailing address

9055 Balboa Ave
San Diego, CA 92123-1509
Phone (619) 849-3331

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
I20260314000454 CA Practitioner - Physician Assistant 9830672120 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Surgical Associates of la Jolla Medical Group, Inc.Group PAC ID 9436105087, 5 clinicians

Practice addresses (Care Compare)

9850 Genesee Ave
Suite 660
La Jolla, CA 92037-1231
Phone (858) 452-5054

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
67652CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Surgical Associates of la Jolla Medical Group, Inc. CurrentSince Feb 16, 2026 Accepting new patients

Locations

9850 Genesee Ave
Ste 660
La Jolla, CA 92037
Phone (619) 452-5054

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1713484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775174400000",
    "number": "1790530152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9055 BALBOA AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231509",
            "telephone_number": "619-849-3331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9850 GENESEE AVE STE 660",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371231",
            "telephone_number": "858-452-5054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPAIN",
        "first_name": "ANNA",
        "middle_name": "RUTH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-19",
        "last_updated": "2026-04-03",
        "certification_date": "2026-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

Verify at the official NPI Registry.