Individual provider Active NPI

Timothy Barounis, M.D.

  • Family Medicine Physician
  • San Diego, CA
National Provider Identifier
1790966877
Registry record updated Aug 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A105853 Issued in CA
Practice address
9909 Mira Mesa Blvd
Ste 200
San Diego, CA 92131-1056
Phone
(858) 657-7750
NPI assigned
Nov 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A105853 CA Primary

Addresses

Primary practice location

9909 Mira Mesa Blvd
Ste 200
San Diego, CA 92131-1056

Mailing address

PO Box 232410
Multi Purpose Facility L - 012
San Diego, CA 92193-2410
Phone (858) 657-7750

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110811000351 CA Practitioner - Family Practice 2264601004 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
105853CAMDClinical Social Worker
A105853CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California Current Accepting new patients
Regents of the University of California CurrentSince Aug 1, 2011 Accepting new patients
Regents of the University of California Family Medicine CurrentSince Aug 1, 2011 Accepting new patients

Locations

9909 Mira Mesa Blvd
Ste 200
San Diego, CA 92131
Phone (858) 657-7750

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1195257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470009600000",
    "number": "1790966877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 232410",
            "address_2": "MULTI PURPOSE FACILITY L - 012",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921932410",
            "telephone_number": "858-657-7750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9909 MIRA MESA BLVD",
            "address_2": "STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921311056",
            "telephone_number": "858-657-7750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAROUNIS",
        "first_name": "TIMOTHY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-17",
        "last_updated": "2016-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A105853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.