NPIMap

Organization Active NPI

Genesis Medical Health a Professional Corporation

  • Psychiatry Physician
  • Escondido, CA
National Provider Identifier
1811742307
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
GENESIS MEDICAL HEALTH A PROFESSIONAL CORPORATION
Practice address
1155 E Grand Ave Ste 10
Escondido, CA 92025-3219
Phone
(760) 644-4027
Fax
(714) 333-4262
NPI assigned
Apr 18, 2024
Last updated
Aug 5, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Authorized official

Name
Rosie CruzNPI 1720910235
Title
Ceo
Phone
(760) 803-2005

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X NU
Neurology Physician 2084N0400X NU
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

1155 E Grand Ave Ste 10
Escondido, CA 92025-3219

Mailing address

1155 E Grand Ave Ste 10
Escondido, CA 92025-3219
Phone (760) 803-2005

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240722000396 CA Part B Supplier - Clinic/Group Practice 9032655576 Receives reassigned benefits from 10 practitioners
Practice locations: Escondido, CA; National City, CA; Vista, CA

National Provider Directory

National Provider Directory

Locations

1155 E Grand Ave
Ste 10
Escondido, CA 92025
Phone (760) 644-4027

3035 E 8th St
Ste 2
National City, CA 91950
Phone (619) 567-9919

Practitioners & affiliated clinicians

Practitioners 11

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": "1713398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722816000000",
    "number": "1811742307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 E GRAND AVE STE 10",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920253219",
            "telephone_number": "760-803-2005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 E GRAND AVE STE 10",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920253219",
            "telephone_number": "760-644-4027",
            "fax_number": "714-333-4262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS MEDICAL HEALTH A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-18",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A",
        "authorized_official_last_name": "CRUZ",
        "authorized_official_first_name": "ROSIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "760-803-2005"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Escondido, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.