Individual provider Active NPI

Alan Craig Wittgrove, M.D.

  • Surgery Physician
  • Del Mar, CA
National Provider Identifier
1942287206
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
G44693 Issued in CA
Practice address
12865 Pointe del Mar Way
Suite 130
Del Mar, CA 92014-3860
Phone
(858) 554-1770
Fax
(858) 554-1771
NPI assigned
Dec 28, 2005
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X G44693 CA Primary
Surgery Physician 208600000X 7110 NV

Addresses

Primary practice location

12865 Pointe del Mar Way
Suite 130
Del Mar, CA 92014-3860

Mailing address

12865 Pointe del Mar Way
Suite 130
Del Mar, CA 92014-3860
Phone (858) 554-1770

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
I20091118000741 CA Practitioner - General SurgeryPractitioner - Other (Physician) 7113065749 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Missouri, Columbia School of Medicine, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

12865 Pointe del Mar Way
Suite 130
Del Mar, CA 92014-3860
Phone (858) 350-4700

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
44693CAMDMarriage & Family Therapist
G44693CAMDSurgery Physician
7110NVMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alvarado Surgical Associates Inc Surgery CurrentSince Jul 19, 2022 Accepting new patients
Alvarado Surgical Associates, a Medical Group, Inc. Current Accepting new patients
Scripps Health Current Accepting new patients
Scripps Health Past Accepting new patients

Locations

12865 Pointe del Mar Way
Ste 130
Del Mar, CA 92014
Phone (858) 350-4700

9834 Genesee Ave
Ste 328
La Jolla, CA 92037
Phone (858) 554-1770

Interoperability endpoints

  • Direct secure messaging: awittgrove28071@scrippshlth.medalliesdirect.net

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1942287206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12865 POINTE DEL MAR WAY",
            "address_2": "SUITE 130",
            "city": "DEL MAR",
            "state": "CA",
            "postal_code": "920143860",
            "telephone_number": "858-554-1770",
            "fax_number": "858-554-1771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12865 POINTE DEL MAR WAY",
            "address_2": "SUITE 130",
            "city": "DEL MAR",
            "state": "CA",
            "postal_code": "920143860",
            "telephone_number": "858-554-1770",
            "fax_number": "858-554-1771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITTGROVE",
        "first_name": "ALAN",
        "middle_name": "CRAIG",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-28",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "G44693",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NV",
            "license": "7110",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Del Mar, CA

Sources for this page

Verify at the official NPI Registry.