NPIMap

Organization Active NPI

Scripps Cardiology Medical Group, Inc.

  • Cardiovascular Disease Physician
  • La Jolla, CA
National Provider Identifier
1851481121
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
SCRIPPS CARDIOLOGY MEDICAL GROUP, INC.
Practice address
9888 Genesee Ave
La Jolla, CA 92037-1205
Phone
(858) 824-2900
Fax
(858) 824-2910
NPI assigned
Oct 14, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Marc K. Effron, M.D.
Title
Director
Phone
(858) 824-2900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X Primary

Addresses

Primary practice location

9888 Genesee Ave
La Jolla, CA 92037-1205

Mailing address

9834 Genesee Ave
Suite 300
La Jolla, CA 92037-1223
Phone (858) 824-2900

Other identifiers 2

IdentifierTypeStateIssuer
GR0066150MedicaidCA
ZZZ52925ZOtherCABLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050610000908 CA Part B Supplier - Clinic/Group Practice 3971547951 Receives reassigned benefits from 19 practitioners
Practice locations: La Jolla, CA

National Provider Directory

National Provider Directory

Locations

4275 Campus Point Ct
San Diego, CA 92121
Phone (858) 336-8490

Practitioners & affiliated clinicians

Practitioners 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1160784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1851481121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9834 GENESEE AVE",
            "address_2": "SUITE 300",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371223",
            "telephone_number": "858-824-2900",
            "fax_number": "858-824-2910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9888 GENESEE AVE",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371205",
            "telephone_number": "858-824-2900",
            "fax_number": "858-824-2910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCRIPPS CARDIOLOGY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EFFRON",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "858-824-2900",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0066150",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ52925Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.