Individual provider Active NPI

Kari Jo Vanocker, PA-C

  • Physician Assistant
  • San Diego, CA
National Provider Identifier
1912213349
Registry record updated Feb 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA21109 Issued in CA
Practice address
3750 Convoy St Ste 201
San Diego, CA 92111-3770
Phone
(858) 278-8300
NPI assigned
Aug 23, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA21109 CA
Physician Assistant 363A00000X PA21109 CA Primary

Addresses

Primary practice location

3750 Convoy St Ste 201
San Diego, CA 92111-3770

Mailing address

4445 Eastgate Mall Ste 105
San Diego, CA 92121-1979
Phone (858) 412-6080

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101118000288 CA Practitioner - Physician Assistant 7618163551 Reassigns benefits to 1 organization

Care Compare profile

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

Practice addresses (Care Compare)

3750 Convoy St
Suite 201
San Diego, CA 92111-3770
Phone (858) 278-8300

4445 Eastgate Mall
San Diego, CA 92121-1979

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Synergy Orthopedic Specialists, Inc. CurrentSince Feb 1, 2023 Accepting new patients
Synergy Orthopedic Specialists, Inc. CurrentSince Feb 1, 2023 Accepting new patients
Sutter Bay Hospitals Past Accepting new patients

Locations

4445 Eastgate Mall
Ste 105
San Diego, CA 92121
Phone (858) 357-9450

3750 Convoy St
Ste 201
San Diego, CA 92111
Phone (858) 278-8031

4445 Eastgate Mall
Ste 103
San Diego, CA 92121
Phone (858) 450-7118

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: kvanocker262535@hisp.ehr.sutterhealth.org

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.

Hospital & facility affiliations 3

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": "1282521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675728000000",
    "number": "1912213349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4445 EASTGATE MALL STE 105",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211979",
            "telephone_number": "858-412-6080",
            "fax_number": "858-412-6376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3750 CONVOY ST STE 201",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921113770",
            "telephone_number": "858-278-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANOCKER",
        "first_name": "KARI",
        "middle_name": "JO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-23",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA21109",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA21109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.