Individual provider Active NPI

Elizabeth Edmonston, RN

  • Diabetes Educator Registered Nurse
  • San Diego, CA
National Provider Identifier
1932873429
Registry record updated Aug 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diabetes Educator Registered NurseTaxonomy code 163WD0400X
License
95183827 Issued in CA
Practice address
10243 Genetic Center Dr
San Diego, CA 92121-6310
Phone
(858) 499-2700
NPI assigned
Aug 6, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diabetes Educator Registered Nurse 163WD0400X 95183827 CA Primary

Addresses

Primary practice location

10243 Genetic Center Dr
San Diego, CA 92121-6310

Mailing address

5651 Copley Dr
San Diego, CA 92111-7903
Phone (858) 499-2700

Other names 1

  • Elizabeth Bernard Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210908001117 CA Practitioner - Registered Dietitian Or Nutrition Professional 3173929700 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sharp Rees-Stealy Medical Group IncGroup PAC ID 8628972759, 872 clinicians

Practice addresses (Care Compare)

10243 Genetic Ctr Dr
San Diego, CA 92121-6310
Phone (858) 499-2600

Merit-based Incentive Payment System (MIPS)

Final score
88.67 of 100Reported as group
Quality
81.04
Promoting interoperability
99
Improvement activities
40
Cost
82.04

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Aug 24, 2021 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Aug 24, 2021 Accepting new patients

Locations

10243 Genetic Center Dr
San Diego, CA 92121
Phone (858) 499-2704

5651 Copley Dr
San Diego, CA 92111
Phone (858) 262-6340

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

Organizations & group practices 2

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": "1628208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628208000000",
    "number": "1932873429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5651 COPLEY DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921117903",
            "telephone_number": "858-499-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10243 GENETIC CENTER DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921216310",
            "telephone_number": "858-499-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMONSTON",
        "first_name": "ELIZABETH",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-06",
        "last_updated": "2021-08-06",
        "certification_date": "2021-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "CA",
            "license": "95183827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "BERNARD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Aug 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.