Active NPI
Nikita Anna Mathew
- Family Medicine Physician
- San Diego, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- R3309
- Practice address
- 2020 Genesee Ave
San Diego, CA 92123-4219 - Phone
- (858) 499-2600
- NPI assigned
- Mar 30, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Family Medicine Physician | 207Q00000X | R3309 | AZ | Primary |
Addresses
Primary practice location
2020 Genesee Ave
San Diego, CA 92123-4219
Mailing address
2020 Genesee Ave
San Diego, CA 92123-4219
Phone (858) 499-2600
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231030000875 | CA | Practitioner - Osteopathic Manipulative Medicine | 7214351097 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Osteopathic Manipulative Medicine
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Sharp Rees-Stealy Medical Group Inc
Practice addresses (Care Compare)
10670 Wexford St
San Diego, CA 92131-3940
Phone (858) 621-4002
8975 Balboa Ave
San Diego, CA 92123-1507
Phone (858) 499-2600
Hospital & facility affiliations
- Sharp Memorial Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 88.67 of 100
- Quality
- 81.04
- Promoting interoperability
- 99
- Improvement activities
- 40
- Cost
- 82.04
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R3309 | AZ | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sharp Rees-Stealy Medical Group, Inc | Family Medicine | Current | Accepting new patients |
| Sharp Rees-Stealy Medical Group, Inc | Current | Accepting new patients | |
| Sharp Rees-Stealy Medical Center | Past | Accepting new patients |
Locations
2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500
2020 Genesee Ave
Fl 3
San Diego, CA 92123
5651 Copley Dr
San Diego, CA 92111
Phone (858) 262-6340
Interoperability endpoints
- nmathew83060@sharphealthcare.direct-ci.com
Organizations & group practices 3
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.
-
- Internal Medicine Physician
- San Diego, CA
- NPI 1285616177
CA, Family Medicine
-
- Optometrist
- San Diego, CA
- NPI 1063172351
-
- Physical Therapist
- Chula Vista, CA
- NPI 1407096589
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": "1585526400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689897600000",
"number": "1902434525",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2020 GENESEE AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921234219",
"telephone_number": "858-499-2600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2020 GENESEE AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921234219",
"telephone_number": "858-499-2600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATHEW",
"first_name": "NIKITA",
"middle_name": "ANNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-30",
"last_updated": "2023-07-21",
"certification_date": "2023-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AZ",
"license": "R3309",
"primary": true
}
],
"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 Jul 21, 2023; 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.