Individual provider Active NPI

Timothy J. Dupont, M.D.

  • Anesthesiology Physician
  • San Diego, CA
National Provider Identifier
1871507111
Registry record updated Dec 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
G49782 Issued in CA
Practice address
7485 Mission Valley Rd Ste 106
San Diego, CA 92108
Phone
(619) 291-3737
Fax
(619) 291-3738
NPI assigned
Jul 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X G49782 CA Primary

Addresses

Primary practice location

7485 Mission Valley Rd Ste 106
San Diego, CA 92108

Mailing address

210 N Tustin Ave
Santa Ana, CA 92705-3807
Phone (714) 347-1053

Other practice location 1

3626 Ruffin Rd
San Diego, CA 92123-1810
Phone (858) 565-9666

Other identifiers 2

IdentifierTypeStateIssuer
00G497820MedicaidCA
00G497820OtherCABLUE SHIELD OF CA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G49782CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: tdupont80970@scrippshlth.medalliesdirect.net

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544140800000",
    "number": "1871507111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 N TUSTIN AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053807",
            "telephone_number": "714-347-1053",
            "fax_number": "714-647-1245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7485 MISSION VALLEY RD STE 106",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92108",
            "telephone_number": "619-291-3737",
            "fax_number": "619-291-3738"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3626 Ruffin Rd",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921231810",
            "country_code": "US",
            "telephone_number": "858-565-9666",
            "fax_number": "858-565-9441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUPONT",
        "first_name": "TIMOTHY",
        "middle_name": "J.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-29",
        "last_updated": "2018-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "G49782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G497820",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA",
            "identifier": "00G497820",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.