Individual provider Active NPI

Jennifer Joy Pendleton, MD

  • Allergy & Immunology Physician
  • San Diego, CA
National Provider Identifier
1821054446
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
A80748 Issued in CA
Practice address
2655 Camino del Rio N Ste 425
San Diego, CA 92108-1633
Phone
(619) 286-6687
Fax
(619) 286-6695
NPI assigned
Apr 22, 2006
Last updated
Oct 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X A80748 CA Primary

Addresses

Primary practice location

2655 Camino del Rio N Ste 425
San Diego, CA 92108-1633

Mailing address

PO Box 603725
Charlotte, NC 28260-3725
Phone (828) 575-2625

Other identifiers 2

IdentifierTypeStateIssuer
00A8074800MedicaidCA
GW221ZOtherCAMEDICARE PTAN

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
I20040712001337 CA Practitioner - Allergy/Immunology 5496733719 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2655 Camino del Rio N
Suite 425
San Diego, CA 92108-1691
Phone (619) 286-6687

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Allergy Partners of California, Inc. Allergy & Immunology CurrentSince Jan 1, 2013 Accepting new patients
Allergy Partners of California, Inc. Allergy & Immunology CurrentSince Jan 1, 2013 Accepting new patients
Scripps Health Current Accepting new patients
Allergy Partners of California, Inc. Allergy & Immunology Current Accepting new patients
Scripps Health Past Accepting new patients
Rady Children's Hospital San Diego Allergy & Immunology Past Accepting new patients

Locations

2655 Camino del Rio N
Ste 120
San Diego, CA 92108
Phone (619) 286-6687

2655 Camino del Rio N
Ste 425
San Diego, CA 92108
Phone (619) 286-6687

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: jpendleton81444@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.

NPI Registry JSON

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

{
    "created_epoch": "1145664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1821054446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 603725",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282603725",
            "telephone_number": "828-575-2625",
            "fax_number": "828-350-2174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2655 CAMINO DEL RIO N STE 425",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081633",
            "telephone_number": "619-286-6687",
            "fax_number": "619-286-6695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENDLETON",
        "first_name": "JENNIFER",
        "middle_name": "JOY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-22",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "CA",
            "license": "A80748",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A8074800",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "GW221Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.