Active NPI
Russell Philip Edwards, M.D.
- Ophthalmology Physician
- San Diego, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- G57008
- Practice address
- 3969 4TH Ave
Ste 301
San Diego, CA 92103-3165 - Phone
- (619) 291-6191
- Fax
- (619) 291-0049
- NPI assigned
- Jun 17, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | G57008 | CA | Primary |
Addresses
Primary practice location
3969 4TH Ave
Ste 301
San Diego, CA 92103-3165
Mailing address
3969 4TH Ave
Ste 301
San Diego, CA 92103-3165
Phone (858) 566-0686
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Scripps Health | Current | Accepting new patients | |
| Scripps Health | Current | Accepting new patients | |
| Emergency and Acute Care Medical Corporation | Current | Accepting new patients | |
| Scripps Health | Ophthalmology | Current | Accepting new patients |
| Scripps Health | Current | Accepting new patients |
Locations
9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123
File 54433
Los Angeles, CA 90074
Phone (858) 784-5645
7901 Frost St
San Diego, CA 92123
Phone (619) 541-3400
3811 Valley Centre Dr
San Diego, CA 92130
Phone (858) 554-8645
4060 4th Ave
Ste 330
San Diego, CA 92103
Phone (619) 291-2274
9730 Summers Ridge Rd
#100
San Diego, CA 92121
Phone (858) 549-7400
Interoperability endpoints
- redwards37450@scrippshlth.medalliesdirect.net
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.
-
- Emergency Medicine Physician
- San Diego, CA
- NPI 1437103942
-
- General Acute Care Hospital
- San Diego, CA
- NPI 1487928891
-
- Home Health Agency
- San Diego, CA
- NPI 1578556114
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- La Jolla, CA
- NPI 1619108503
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118966400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549843200000",
"number": "1922003706",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3969 4TH AVE",
"address_2": "STE 301",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921033165",
"telephone_number": "858-566-0686"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3969 4TH AVE",
"address_2": "STE 301",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921033165",
"telephone_number": "619-291-6191",
"fax_number": "619-291-0049"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "RUSSELL",
"middle_name": "PHILIP",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-17",
"last_updated": "2019-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "CA",
"license": "G57008",
"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 Feb 11, 2019; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.