Individual provider Active NPI

Max Caccese, M.D.

  • Emergency Medicine Physician
  • San Diego, CA
National Provider Identifier
1922534494
Registry record updated Jul 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A157113 Issued in CA
Practice address
200 W Arbor Dr
#8676
San Diego, CA 92103-9000
Phone
(619) 543-6463
Fax
(619) 543-3115
NPI assigned
May 3, 2017
Last updated
Jul 27, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X A157113 CA Primary

Addresses

Primary practice location

200 W Arbor Dr
#8676
San Diego, CA 92103-9000

Mailing address

200 W Arbor Dr
#8676
San Diego, CA 92103-9000
Phone (619) 543-6463

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
I20200605001577 CA Practitioner - Emergency Medicine 2668893298 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Monterey Bay Observation MedicineGroup PAC ID 1052630514, 32 clinicians

Practice addresses (Care Compare)

23625 Holman Hwy
Monterey, CA 93940-5902
Phone (831) 625-4900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.53 of 100Reported as individual
Quality
97.98
Improvement activities
0
Cost
82.67

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A157113CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Monterey Bay Observation Medicine Emergency Medicine CurrentSince Jun 1, 2021 Accepting new patients
Community Hospital of the Monterey Peninsula CurrentSince May 1, 2021 Accepting new patients
Cep America - California Emergency Medicine CurrentSince Jun 1, 2020 Accepting new patients
Cep America - California Emergency Medicine Current Accepting new patients
Cep America-California Emergency Medicine CurrentSince Jun 1, 2020 Accepting new patients
Community Hospital of the Monterey Peninsula CurrentSince May 1, 2021 Accepting new patients

Locations

751 Medical Center Ct
Chula Vista, CA 91911
Phone (619) 482-3639

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 900-3125

23625 Wr Holman Hwy
Monterey, CA 93940
Phone (831) 622-2708

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1493769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627344000000",
    "number": "1922534494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "address_2": "#8676",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000",
            "telephone_number": "619-543-6463",
            "fax_number": "619-543-3115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "address_2": "#8676",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000",
            "telephone_number": "619-543-6463",
            "fax_number": "619-543-3115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CACCESE",
        "first_name": "MAX",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-03",
        "last_updated": "2021-07-27",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A157113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.