NPIMap

Individual provider Active NPI

Mathew S Isho, MD

  • Colon & Rectal Surgery Physician
  • San Diego, CA
National Provider Identifier
1841235645
Registry record updated Jun 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
A93470 Issued in CA
Practice address
550 Washington St
Suite 821
San Diego, CA 92103-2213
Phone
(619) 686-4011
Fax
(619) 686-4041
NPI assigned
Jun 17, 2006
Last updated
Jun 12, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery Physician 208C00000X A93470 CA Primary

Addresses

Primary practice location

550 Washington St
Suite 821
San Diego, CA 92103-2213

Mailing address

4060 4TH Ave
Ste 510
San Diego, CA 92103-2121
Phone (619) 686-4011

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060710000279 CA Practitioner - General SurgeryPractitioner - Colorectal Surgery (Proctology) 3476522459 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Colorectal Surgery (Proctology)
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
On Call Specialists Medical Group of San Diego IncGroup PAC ID 7911395231, 145 clinicians

Practice addresses (Care Compare)

4060 4TH Ave
Suite 510
San Diego, CA 92103-2121
Phone (619) 686-4011

4077 5TH Ave
San Diego, CA 92103-2105
Phone (619) 359-6600

550 Washington St
San Diego, CA 92103-2232
Phone (619) 359-6600

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy97
Hernia repair - groin (open)1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A93470CAMDColon & Rectal Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Current Accepting new patients
Emergency and Acute Care Medical Corporation CurrentSince Nov 12, 2009 Accepting new patients
Scripps Health Current Accepting new patients
Scripps Health CurrentSince Nov 10, 2009 Accepting new patients
Scripps Health CurrentSince Nov 10, 2009 Accepting new patients
On Call Specialists Medical Group of San Diego, Inc. CurrentSince Jun 1, 2023 Accepting new patients
Mathew Isho, M.D., P.C. CurrentSince Apr 30, 2003 Accepting new patients
Sharp Memorial Hospital Past Accepting new patients
Sharp Coronado Hospital and Healthcare Center Past Accepting new patients
Scripps Health Past Accepting new patients
Grossmont Hospital Corporation Past Accepting new patients
Scripps Health Past Accepting new patients
Sdosc, LP PastSince Jul 1, 2008 Accepting new patients

Locations

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

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

4060 4th Ave
Ste 510
San Diego, CA 92103
Phone (619) 369-8115

4077 5th Ave
San Diego, CA 92103
Phone (619) 260-7245

550 Washington St
Ste 821
San Diego, CA 92103
Phone (619) 686-4011

7901 Frost St
San Diego, CA 92123
Phone (619) 541-3400

650 E Devon Ave
Ste 165
Itasca, IL 60143
Phone (630) 285-1040

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: misho80442@scrippshlth.medalliesdirect.net

Organizations & group practices 13

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.

View all 13

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": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591920000000",
    "number": "1841235645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4060 4TH AVE",
            "address_2": "STE 510",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032121",
            "telephone_number": "619-686-4011",
            "fax_number": "619-686-4041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 WASHINGTON ST",
            "address_2": "SUITE 821",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032213",
            "telephone_number": "619-686-4011",
            "fax_number": "619-686-4041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISHO",
        "first_name": "MATHEW",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-17",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "CA",
            "license": "A93470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.