Individual provider Active NPI

Mark William Bondi, PH.D.

  • Clinical Neuropsychologist
  • San Diego, CA
National Provider Identifier
1922030253
Registry record updated Jul 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PSY13383 Issued in CA
Practice address
3350 La Jolla Village Dr
VA San Diego Healthcare System (116B)
San Diego, CA 92161-0002
Phone
(858) 552-8585
Fax
(858) 642-1218
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2016

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY13383 CA
Adult Development & Aging Psychologist 103TA0700X
Clinical Psychologist 103TC0700X PSY13383 CA
Clinical Neuropsychologist 103G00000X PSY13383 CA Primary

Addresses

Primary practice location

3350 La Jolla Village Dr
VA San Diego Healthcare System (116B)
San Diego, CA 92161-0002

Mailing address

PO Box 232410
San Diego, CA 92193-2410
Phone (858) 534-6200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080123000364 CA Practitioner - Clinical Psychologist 8820170335 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
90.77 of 100Reported as group
Quality
84.13
Promoting interoperability
100
Improvement activities
40
Cost
73.88

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY13383CAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California Current Accepting new patients
Regents of the University of California CurrentSince Feb 12, 2013 Accepting new patients
Regents of the University of California Clinical Neuropsychologist CurrentSince Feb 12, 2013 Accepting new patients
Mark W. Bondi, PHD, Abpp-CN, Psychologist, Apc Clinical Neuropsychologist CurrentSince Apr 24, 2023 Accepting new patients
Regents of the University of California Ucsd Head and Neck Surgery Past Accepting new patients

Locations

2240 Encinitas Blvd
Ste D192
Encinitas, CA 92024

9500 Gilman Dr
Ste 2069
La Jolla, CA 92093

9500 Gilman Dr
Dept 2
La Jolla, CA 92093
Phone (858) 534-3755

File 57326
Los Angeles, CA 90074

200 W Arbor Dr
#8201
San Diego, CA 92103
Phone (858) 534-6290

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

440 Stevens Ave
Ste 200
Solana Beach, CA 92075
Phone (443) 534-4268

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469577600000",
    "number": "1922030253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 232410",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921932410",
            "telephone_number": "858-534-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 LA JOLLA VILLAGE DR",
            "address_2": "VA SAN DIEGO HEALTHCARE SYSTEM (116B)",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921610002",
            "telephone_number": "858-552-8585",
            "fax_number": "858-642-1218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONDI",
        "first_name": "MARK",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2016-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY13383",
            "primary": false
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY13383",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "PSY13383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.