Individual provider Active NPI

Lewis H Self, MD

  • Internal Medicine Physician
  • Encinitas, CA
National Provider Identifier
1942368907
Registry record updated Jan 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
C50733 Issued in CA
Practice address
354 Santa Fe Dr
Encinitas, CA 92024-5142
Phone
(760) 230-2252
Fax
(760) 230-2253
NPI assigned
Dec 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 7570 NV
Internal Medicine Physician 207R00000X C50733 CA Primary

Addresses

Primary practice location

354 Santa Fe Dr
Encinitas, CA 92024-5142

Mailing address

PO Box 231189
Encinitas, CA 92023-1189
Phone (760) 230-2252

Other identifiers 1

IdentifierTypeStateIssuer
002019796MedicaidNV

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
I20121206000117 CA Practitioner - Internal Medicine 9234114455 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Texas Tech University Health Science Center School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
24 On Physicians of California PCGroup PAC ID 7012228992, 58 clinicians

Practice addresses (Care Compare)

1415 Ross Ave
El Centro, CA 92243-4306
Phone (760) 339-4045

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.87 of 100Reported as group
Quality
71.11
Improvement activities
40
Cost
69.18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7570NVMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Current Accepting new patients
24 On Physicians of California, PC CurrentSince May 5, 2018 Accepting new patients
Encinitas Palliative Care Associates, Inc. Internal Medicine Past Accepting new patients

Locations

207 W Legion Rd
Brawley, CA 92227
Phone (760) 351-3333

1415 Ross Ave
El Centro, CA 92243
Phone (760) 339-4045

Interoperability endpoints

  • Direct secure messaging: lself28359@scrippshlth.medalliesdirect.net

Organizations & group practices 3

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 1

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": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484870400000",
    "number": "1942368907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 231189",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920231189",
            "telephone_number": "760-230-2252",
            "fax_number": "760-230-2253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "354 SANTA FE DR",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920245142",
            "telephone_number": "760-230-2252",
            "fax_number": "760-230-2253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELF",
        "first_name": "LEWIS",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2017-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "7570",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C50733",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002019796",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Encinitas, CA

Sources for this page

Verify at the official NPI Registry.