Individual provider Active NPI

Dannie Lynn Perdomo, DO

  • General Practice Physician
  • San Diego, CA
National Provider Identifier
1861997561
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
23109 Issued in CA
Practice address
3900 Fifth Ave Ste 110
San Diego, CA 92103-3122
Phone
(858) 554-1212
NPI assigned
Mar 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 23109 CA Primary
General Practice Physician 208D00000X 0102207353 VA

Addresses

Primary practice location

3900 Fifth Ave Ste 110
San Diego, CA 92103-3122

Mailing address

3900 5TH Ave Ste 110
San Diego, CA 92103-3122
Phone (858) 554-1212

Other practice location 1

6386 Alvarado Ct Ste 101
San Diego, CA 92120-4906
Phone (858) 900-9490

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
I20240816001812 CA Practitioner - General Practice 4789066028 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Lake Erie Col of Osteo Med at Seton Hill Univ, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Monica Perlman MD IncGroup PAC ID 8820035884, 357 clinicians

Practice addresses (Care Compare)

6386 Alvarado CT
Suite 101
San Diego, CA 92120-4906
Phone (858) 900-9490

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.17 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
73.9

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23109CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Monica Perlman MD Inc. CurrentSince Aug 5, 2024 Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

9850 Genesee Ave
Ste 320
La Jolla, CA 92037
Phone (858) 864-9800

6386 Alvarado Ct
Ste 101
San Diego, CA 92120
Phone (619) 265-1237

3737 Moraga Ave
Ste B103
San Diego, CA 92117
Phone (858) 799-0855

3900 5th Ave
Ste 110
San Diego, CA 92103
Phone (619) 291-5474

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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 2

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": "1522022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1861997561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 5TH AVE STE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921033122",
            "telephone_number": "858-554-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 FIFTH AVE STE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921033122",
            "telephone_number": "858-554-1212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6386 Alvarado Ct Ste 101",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921204906",
            "country_code": "US",
            "telephone_number": "858-900-9490",
            "fax_number": "858-795-1195",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERDOMO",
        "first_name": "DANNIE",
        "middle_name": "LYNN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-26",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "23109",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "0102207353",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.