Organization Active NPI

Ned H. Chambers, M.D. Inc.

Doing business as Shelter Island Medical Group

  • Multi-Specialty Clinic/Center
  • San Diego, CA
National Provider Identifier
1790886216
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
License
A32874 Issued in CA
Legal business name
NED H. CHAMBERS, M.D. INC.
Doing business as
Shelter Island Medical Group
Practice address
1370 Rosecrans St
Ste a
San Diego, CA 92106-2638
Phone
(619) 223-2668
Fax
(619) 223-2698
NPI assigned
Sep 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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

Authorized official

Name
Melanie A McIntyre
Title
Office Manager
Phone
(619) 223-2668

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X
Multi-Specialty Clinic/Center 261QM1300X A32874 CA Primary

Addresses

Primary practice location

1370 Rosecrans St
Ste a
San Diego, CA 92106-2638

Mailing address

1370 Rosecrans St
Ste a
San Diego, CA 92106-2638
Phone (619) 223-2668

Other identifiers 1

IdentifierTypeStateIssuer
1699015529OtherCANPI

Other names 1

  • Shelter Island Medical Group Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230905003045 CA Part B Supplier - Clinic/Group Practice 6103860093 Receives reassigned benefits from 1 practitioner
Practice locations: San Diego, CA

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0723119Shelter Island Medical Group Inc1370 Rosecrans St Ste a, San Diego, CA 92106Certificate of waiverDec 31, 2026

National Provider Directory

National Provider Directory

Locations

1370 Rosecrans St
San Diego, CA 92106
Phone (619) 223-2668

1370 Rosecrans St
Ste Ab
San Diego, CA 92106

1370 Rosecrans St
Ste A
San Diego, CA 92106
Phone (619) 223-2668

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689638400000",
    "number": "1790886216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1370 ROSECRANS ST",
            "address_2": "STE A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921062638",
            "telephone_number": "619-223-2668",
            "fax_number": "619-223-2698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1370 ROSECRANS ST",
            "address_2": "STE A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921062638",
            "telephone_number": "619-223-2668",
            "fax_number": "619-223-2698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NED H. CHAMBERS, M.D. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A",
        "authorized_official_last_name": "MCINTYRE",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "619-223-2668"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "CA",
            "license": "A32874",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1699015529",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shelter Island Medical Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Shelter Island Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2023; 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.