Individual provider Active NPI

Michaela Staley, M.D.

  • Family Medicine Physician
  • San Diego, CA
National Provider Identifier
1912438250
Registry record updated May 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A157772 Issued in CA
Practice address
3177 Ocean View Blvd
San Diego, CA 92113-1432
Phone
(619) 662-4100
NPI assigned
Mar 27, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A157772 CA Primary

Addresses

Primary practice location

3177 Ocean View Blvd
San Diego, CA 92113-1432

Mailing address

3177 Ocean View Blvd
San Diego, CA 92113-1432
Phone (619) 662-4100

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
I20200505002699 CA Practitioner - Family Practice 2365873494 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Geisel School of Medicine at Dartmouth, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scripps Mercy Physicians Cardiology Medical CorporationGroup PAC ID 0143264879, 34 clinicians

Practice addresses (Care Compare)

1136 D Ave
National City, CA 91950-3412
Phone (619) 662-4100

4077 5TH Ave
San Diego, CA 92103-2105
Phone (619) 260-7245

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A157772CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centro de Salud de la Comunidad de San Ysidro Inc CurrentSince Mar 30, 2020 Accepting new patients
Centro de Salud de la Comunidad de San Ysidro, Inc. CurrentSince Mar 30, 2020 Accepting new patients
Scripps Health Current Accepting new patients
Centro de Salud de la Comunidad de San Ysidro, Inc. Current Accepting new patients
Scripps Mercy Physicians Cardiology Medical Corporation CurrentSince Jun 1, 2020 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

3177 Ocean View Blvd
San Diego, CA 92113
Phone (619) 231-9300

4077 5th Ave
San Diego, CA 92103
Phone (619) 260-7245

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

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

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: mstaley41735@scrippshlth.medalliesdirect.net
  • Direct secure messaging: mstaley18996@syhealth.direct-ci.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.

Hospital & facility affiliations 1

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": "1490572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652918400000",
    "number": "1912438250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3177 OCEAN VIEW BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921131432",
            "telephone_number": "619-662-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3177 OCEAN VIEW BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921131432",
            "telephone_number": "619-662-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALEY",
        "first_name": "MICHAELA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-27",
        "last_updated": "2022-05-19",
        "certification_date": "2022-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A157772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.