Individual provider Active NPI

Brian J. Shore, M.D.

  • Vascular & Interventional Radiology Physician
  • La Jolla, CA
National Provider Identifier
1811948755
Registry record updated Feb 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
A89549 Issued in CA
Practice address
10666 N Torrey Pines Rd
La Jolla, CA 92037-1027
Phone
(858) 626-7275
Fax
(858) 626-4085
NPI assigned
May 15, 2006
Last updated
Feb 6, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X A89549 CA
Vascular & Interventional Radiology Physician 2085R0204X A89549 CA Primary

Addresses

Primary practice location

10666 N Torrey Pines Rd
La Jolla, CA 92037-1027

Mailing address

10790 Rancho Bernardo Rd
San Diego, CA 92127-5705
Phone (858) 626-7275

Other identifiers 1

IdentifierTypeStateIssuer
00A895490MedicaidCA

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
I20060623000228 CA Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 4587676192 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional RadiologyAlso: Diagnostic Radiology
Education
Tulane University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scripps HealthGroup PAC ID 9234033853, 1,450 clinicians

Practice addresses (Care Compare)

9898 Genesee Ave
La Jolla, CA 92037-1205
Phone (858) 455-9100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A89549CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Current Accepting new patients
Scripps Health Current Accepting new patients
Scripps Health CurrentSince Jul 1, 2013 Accepting new patients
Scripps Health Current Accepting new patients
Scripps Health CurrentSince Jul 1, 2013 Accepting new patients
La Jolla Radiology Medical Group - Diagnosis, Inc. Diagnostic Radiology Past Accepting new patients

Locations

435 H St
Chula Vista, CA 91910
Phone (619) 691-7000

354 Santa Fe Dr
Encinitas, CA 92024
Phone (760) 230-2251

10666 N Torrey Pines Rd
La Jolla, CA 92037
Phone (858) 554-2626

9850 Genesee Ave
Ste 170B
La Jolla, CA 92037
Phone (858) 626-5225

9850 Genesee Ave
Ste 560
La Jolla, CA 92037
Phone (858) 452-0306

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

9898 Genesee Ave
La Jolla, CA 92037
Phone (858) 824-5222

File 54433
Los Angeles, CA 90074
Phone (858) 784-5645

10790 Rancho Bernardo Rd
San Diego, CA 92127
Phone (858) 554-2626

3811 Valley Centre Dr
San Diego, CA 92130
Phone (858) 554-8645

9730 Summers Ridge Rd
#100
San Diego, CA 92121
Phone (858) 549-7400

916 Sycamore Ave
Vista, CA 92081
Phone (760) 599-9545

Interoperability endpoints

  • Direct secure messaging: bshore19153@scrippshlth.medalliesdirect.net

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549411200000",
    "number": "1811948755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10790 RANCHO BERNARDO RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275705",
            "telephone_number": "858-626-7275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10666 N TORREY PINES RD",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371027",
            "telephone_number": "858-626-7275",
            "fax_number": "858-626-4085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORE",
        "first_name": "BRIAN",
        "middle_name": "J.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2019-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A89549",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "CA",
            "license": "A89549",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A895490",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

Verify at the official NPI Registry.