Active NPI
Dulguun Uyenbat, PA-C
- Physician Assistant
- San Diego, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 61623
- Practice address
- 1809 National Ave
San Diego, CA 92113-2113 - Phone
- (619) 515-2300
- NPI assigned
- Mar 31, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 085007809 | IL | |
| Physician Assistant | 363A00000X | 61623 | CA | Primary |
| Family Medicine Physician | 207Q00000X | 085.007809 | IL |
Addresses
Primary practice location
1809 National Ave
San Diego, CA 92113-2113
Mailing address
823 Gateway Center Way
San Diego, CA 92102-4541
Phone (619) 515-2300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4065 3Rd Ave
San Diego, CA 92103-2184
Phone (619) 515-2545
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61623 | CA | MD | Dentist |
| 085.007809 | IL | MD | Family Medicine Physician |
| 085007809 | IL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Health Centers of San Diego, Inc | Current | Accepting new patients | |
| Family Health Centers of San Diego Inc | Current | Accepting new patients |
Locations
823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323
1809 National Ave
San Diego, CA 92113
Phone (619) 515-2500
Interoperability endpoints
- dulguun.uyenbat.1@3836.direct.athenahealth.com
Organizations & group practices 5
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.
-
dba Logan Heights Family Health Center
- Federally Qualified Health Center (FQHC)
- San Diego, CA
- NPI 1447281936
-
- Family Medicine Physician
- Chicago, IL
- NPI 1114397056
-
- Family Medicine Physician
- North Chicago, IL
- NPI 1518145176
-
dba FamilyHealth at City College
- Federally Qualified Health Center (FQHC)
- San Diego, CA
- NPI 1952729303
-
dba Escondido Physical Health and Wellness
- Federally Qualified Health Center (FQHC)
- Escondido, CA
- NPI 1356178180
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585612800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665964800000",
"number": "1881222354",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "823 GATEWAY CENTER WAY",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921024541",
"telephone_number": "619-515-2300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1809 NATIONAL AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921132113",
"telephone_number": "619-515-2300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UYENBAT",
"first_name": "DULGUUN",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-03-31",
"last_updated": "2022-10-17",
"certification_date": "2022-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IL",
"license": "085007809",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "61623",
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "085.007809",
"primary": false
}
],
"identifiers": [],
"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 Oct 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.