Individual provider Active NPI

Stephen William Bickler, M.D.

  • Pediatric Surgery Physician
  • San Diego, CA
National Provider Identifier
1891866653
Registry record updated Nov 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
G58535 Issued in CA
Practice address
8010 Frost St
Suite 414
San Diego, CA 92123-2778
Phone
(858) 966-7711
NPI assigned
Nov 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X G58535 CA
Pediatric Surgery Physician 2086S0120X G58535 CA Primary

Addresses

Primary practice location

8010 Frost St
Suite 414
San Diego, CA 92123-2778

Mailing address

3860 Calle Fortunada
Suite 210
San Diego, CA 92123-4800
Phone (858) 309-6303

Other identifiers 1

IdentifierTypeStateIssuer
00G585350MedicaidCA

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
I20101006000986 CA Practitioner - General SurgeryPractitioner - Pediatric Medicine 5991997116 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G58535CAMDPediatric Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rady Children's Hospital San Diego CurrentSince Apr 27, 2010 Accepting new patients
Rady Children's Hospital San Diego CurrentSince Apr 27, 2010 Accepting new patients
Marilyn Kaufhold, M.D., a Medical Corporation Past Accepting new patients
Regents of the University of California Past Accepting new patients

Locations

25170 Hancock Ave
Murrieta, CA 92562
Phone (858) 757-3277

8010 Frost St
Ste 414
San Diego, CA 92123
Phone (858) 966-7711

3020 Childrens Way
San Diego, CA 92123
Phone (858) 966-5841

3030 Childrens Way
Fl 1
San Diego, CA 92123
Phone (858) 966-8800

3020 Childrens Way
#5003
San Diego, CA 92123
Phone (858) 309-6300

Interoperability endpoints

  • Direct secure messaging: sbickler9028@radychildrens.direct-ci.com

Organizations & group practices 4

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": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320624000000",
    "number": "1891866653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3860 CALLE FORTUNADA",
            "address_2": "SUITE 210",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234800",
            "telephone_number": "858-309-6303",
            "fax_number": "858-309-6301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8010 FROST ST",
            "address_2": "SUITE 414",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921232778",
            "telephone_number": "858-966-7711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BICKLER",
        "first_name": "STEPHEN",
        "middle_name": "WILLIAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2011-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "G58535",
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "CA",
            "license": "G58535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G585350",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.