Individual provider Active NPI

Sofia H Qureshi, M.D.

  • Family Medicine Physician
  • San Ysidro, CA
National Provider Identifier
1902197544
Registry record updated Feb 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
188057 Issued in CA
Practice address
4004 Beyer Blvd
San Ysidro, CA 92173-2007
Phone
(619) 662-4100
NPI assigned
May 1, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 46286 KY
Family Medicine Physician 207Q00000X TP037 KY
Family Medicine Physician 207Q00000X 188057 CA Primary

Addresses

Primary practice location

4004 Beyer Blvd
San Ysidro, CA 92173-2007

Mailing address

4004 Beyer Blvd
San Ysidro, CA 92173-2007
Phone (619) 662-4100

Other identifiers 2

IdentifierTypeStateIssuer
0085346MedicaidOH
7100252500MedicaidKY

Other names 1

  • Sofia Qureshi Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130617000234 KY Practitioner - Family Practice 2264671601 Reassigns benefits to 1 organization
I20240514000943 CA Practitioner - Family Practice 2264671601 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1620 Alpine Blvd
Suite 110
Alpine, CA 91901-1103
Phone (619) 662-4100

1637 3Rd Ave
Suite B
Chula Vista, CA 91911-5823
Phone (619) 662-4100

4004 Beyer Blvd
San Ysidro, CA 92173-2007
Phone (619) 428-4463

4050 Beyer Blvd
San Ysidro, CA 92173-2007
Phone (619) 662-4100

678 3Rd Ave
Chula Vista, CA 91910-5736
Phone (619) 662-4100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
188057CAMDFamily Medicine Physician
46286KYMDFamily Medicine Physician
TP037KYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centro de Salud de la Comunidad de San Ysidro Inc CurrentSince Mar 2, 2024 Accepting new patients
Summit Medical Group, Inc. CurrentSince Jul 1, 2013 Accepting new patients
Summit Medical Group, Inc. Family Medicine CurrentSince Jul 1, 2013 Accepting new patients
Centro de Salud de la Comunidad de San Ysidro, Inc. CurrentSince Mar 2, 2024 Accepting new patients
Centro de Salud de la Comunidad de San Ysidro, Inc. Current Accepting new patients
Summit Medical Group, Inc Family Medicine Current Accepting new patients

Locations

1637 Third Ave
Ste B
Chula Vista, CA 91911
Phone (619) 425-1780

1136 D Ave
National City, CA 91950
Phone (619) 336-2300

1601 Precision Park Ln
San Ysidro, CA 92173
Phone (619) 205-4585

4004 Beyer Blvd
San Ysidro, CA 92173
Phone (619) 428-1330

334 Thomas More Pkwy
Ste 200
Crestview Hills, KY 41017
Phone (859) 344-3737

334 Thomas More Pkwy
Crestview Hills, KY 41017
Phone (859) 331-6065

405 Violet Rd
Crittenden, KY 41030
Phone (859) 428-1610

1980 Litton Ln
Hebron, KY 41048
Phone (859) 334-8700

2626 Alexandria Pike
Highland Heights, KY 41076
Phone (859) 757-0434

2300 Chamber Center Dr
Lakeside Park, KY 41017
Phone (859) 341-3114

1400 Grand Ave
Newport, KY 41071
Phone (859) 905-3070

300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217

Interoperability endpoints

  • Direct secure messaging: squreshi47845@syhealth.direct-ci.com
  • Direct secure messaging: squreshi152994@direct-prd.stelizabeth.com

Organizations & group practices 6

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": "1304208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707609600000",
    "number": "1902197544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4004 BEYER BLVD",
            "city": "SAN YSIDRO",
            "state": "CA",
            "postal_code": "921732007",
            "telephone_number": "619-662-4100",
            "fax_number": "859-331-2021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4004 BEYER BLVD",
            "city": "SAN YSIDRO",
            "state": "CA",
            "postal_code": "921732007",
            "telephone_number": "619-662-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QURESHI",
        "first_name": "SOFIA",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-01",
        "last_updated": "2024-02-11",
        "certification_date": "2024-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "46286",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "TP037",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "188057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0085346",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100252500",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SOFIA",
            "last_name": "QURESHI",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Ysidro, CA

Sources for this page

Verify at the official NPI Registry.