Individual provider Active NPI

Cory Nelkin, D.O.

  • Internal Medicine Physician
  • Poway, CA
National Provider Identifier
1831475136
Registry record updated Sep 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A13311 Issued in CA
Practice address
15615 Pomerado Rd
Poway, CA 92064-2405
Phone
(858) 613-4000
NPI assigned
Oct 31, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X P8058 TX
Internal Medicine Physician 207R00000X L0103652-0328 TX
Internal Medicine Physician 207R00000X 20A13311 CA Primary

Addresses

Primary practice location

15615 Pomerado Rd
Poway, CA 92064-2405

Mailing address

285 N El Camino Ste. 117-118
Encinitas, CA 92024-5383
Phone (877) 381-4115

Other practice location 1

900 E 8th Ave
Fort Worth, TX 76104
Phone (817) 336-2100

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
I20140731002767 CA Practitioner - Internal Medicine 9739305459 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Kansas School of Med (KC/Wich/Sal), 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

354 Santa Fe Dr
Encinitas, CA 92024-5142
Phone (760) 230-2551

Hospital & facility affiliations

  • Scripps Memorial Hospital - Encinitas Hospital, Encinitas, CA, CCN 050503

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A13311CAMDInternal Medicine Physician
L0103652-0328TXMDInternal Medicine Physician
P8058TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North County Inpatient Medical Alliance, a Medical Group, Inc CurrentSince Feb 27, 2021 Accepting new patients
Scripps Health Current Accepting new patients
Enlightened Healthcare Alliance Medical Corporation Internal Medicine CurrentSince Jan 15, 2021 Accepting new patients
Galen Inpatient Physicians, PC Current Accepting new patients
Galen Inpatient Physicians, PC CurrentSince Jul 1, 2014 Accepting new patients
Galen Inpatient Physicians PC CurrentSince Jul 1, 2014 Accepting new patients
Scripps Health Past Accepting new patients
Premier Surgical Partners Inc Past Accepting new patients
Encinitas Palliative Care Associates, Inc. Internal Medicine Past Accepting new patients

Locations

662 Encinitas Blvd
Ste 204
Encinitas, CA 92024
Phone (760) 203-5545

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

320 Santa Fe Dr
Ste 107C
Encinitas, CA 92024
Phone (760) 230-8994

662 Encinitas Blvd
Ste 220
Encinitas, CA 92024
Phone (760) 230-2251

320 Santa Fe Dr
Encinitas, CA 92024
Phone (760) 901-5200

2185 Citracado Pkwy
Escondido, CA 92029
Phone (442) 281-5000

2185 Citracado Pkwy
#1182
Escondido, CA 92029
Phone (805) 473-7626

1509 Wilson Ter
Glendale, CA 91206
Phone (818) 409-8071

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

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

15615 Pomerado Rd
Poway, CA 92064
Phone (858) 613-4000

Interoperability endpoints

  • Direct secure messaging: cnelkin400326@scrippshlth.medalliesdirect.net

Organizations & group practices 9

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.

Hospital & facility affiliations 1

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": "1320019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1831475136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 N EL CAMINO STE. 117-118",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920245383",
            "telephone_number": "877-381-4115",
            "fax_number": "858-901-1461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15615 POMERADO RD",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642405",
            "telephone_number": "858-613-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 E 8th Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "76104",
            "country_code": "US",
            "telephone_number": "817-336-2100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELKIN",
        "first_name": "CORY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-10-31",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "P8058",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "L0103652-0328",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A13311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poway, CA

Sources for this page

Verify at the official NPI Registry.