NPIMap

Organization Active NPI

Scripps Health

  • Clinical Medical Laboratory
  • Oceanside, CA
National Provider Identifier
1861018574
Registry record updated Mar 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
SCRIPPS HEALTH
Practice address
2205 Vista Way
Oceanside, CA 92054-5661
Phone
(760) 704-5400
NPI assigned
Jun 18, 2020
Last updated
Mar 16, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2022

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

Authorized official

Name
Richard Rothberger
Title
Corp Executive VP/Cfo
Phone
(858) 678-6919

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X NU Primary

Addresses

Primary practice location

2205 Vista Way
Oceanside, CA 92054-5661

Mailing address

10790 Rancho Bernardo Rd
San Diego, CA 92127-5705
Phone (760) 704-5400

Other names 1

  • Jefferson Medical Lab Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060114000013 CA Part B Supplier - Independent Clinical Laboratory 9234033853 4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: La Jolla, CA; Oceanside, CA; San Diego, CA

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0691203Scripps Medical Laboratory- Jefferson2205 Vista Way, Oceanside, CA 92054AccreditationJan 24, 2028
05D2197092Scripps Medical Center Jefferson2205 Vista Way, Oceanside, CA 92054Provider-performed microscopyOct 20, 2026

National Provider Directory

National Provider Directory
Tax ID family
Scripps Mem Hosp-la Jol27 organizations share this tax ID, including this one

Other organizations with this tax ID 26

Organizations that report the same tax identification number in the National Provider Directory.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1592438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647388800000",
    "number": "1861018574",
    "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": "760-704-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 VISTA WAY",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920545661",
            "telephone_number": "760-704-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCRIPPS HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-18",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A",
        "authorized_official_last_name": "ROTHBERGER",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "CORP EXECUTIVE VP/CFO",
        "authorized_official_telephone_number": "858-678-6919"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jefferson Medical Lab",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Oceanside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.