Individual provider Active NPI

Mark Peter Nespeca, M.D.

  • Neurology with Special Qualifications in Child Neurology Physician
  • San Diego, CA
National Provider Identifier
1942371703
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
G65509 Issued in CA
Practice address
200 W Arbor Dr
San Diego, CA 92103-9000
Phone
(800) 926-8273
Fax
(888) 539-8781
NPI assigned
Nov 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X G65509 CA Primary
Pediatrics Physician 208000000X G65509 CA

Addresses

Primary practice location

200 W Arbor Dr
San Diego, CA 92103-9000

Mailing address

File 57326
Los Angeles, CA 90074-7326
Phone (858) 249-6748

Other practice location 1

3030 Childrens Way
San Diego, CA 92123-4232
Phone (858) 966-5819

Other practice location 2

3020 Childrens Way
San Diego, CA 92123-4223
Phone (800) 926-8273

Other identifiers 1

IdentifierTypeStateIssuer
00G655090MedicaidCA

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
I20090717000086 CA Practitioner - NeurologyPractitioner - Pediatric Medicine 5193877488 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NeurologyAlso: Pediatric Medicine
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3010 Childrens Way
San Diego, CA 92123-4223
Phone (858) 576-1700

3020 Children's Way
San Diego, CA 92123-4223
Phone (858) 576-1700

3030 Childrens Way
San Diego, CA 92123-4232
Phone (858) 576-1700

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
65509CAMDMarriage & Family Therapist
G65509CAMDNeurology with Special Qualifications in Child Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince Oct 19, 2024 Accepting new patients
Regents of the University of California Neurology With Special Qualifications in Child Neurology CurrentSince Oct 19, 2024 Accepting new patients
Rady Children's Hospital San Diego CurrentSince May 28, 2011 Accepting new patients
Rady Children's Hospital San Diego Pediatrics CurrentSince May 28, 2011 Accepting new patients
Children's Specialists of San Diego, Inc. (CSSD) Pediatrics Past Accepting new patients
Regents of the University of California Ucsd Head and Neck Surgery Past Accepting new patients

Locations

File 57326
Los Angeles, CA 90074

25170 Hancock Ave
Murrieta, CA 92562
Phone (858) 757-3277

4250 1st Ave
San Diego, CA 92103
Phone (415) 290-8175

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

8010 Frost St
Ste 510
San Diego, CA 92123
Phone (858) 278-9900

3030 Childrens Way
San Diego, CA 92123
Phone (858) 966-4003

3020 Childrens Way
#5003
San Diego, CA 92123
Phone (858) 309-6300

3020 Childrens Way
San Diego, CA 92123
Phone (858) 966-5841

8001 Frost St
San Diego, CA 92123
Phone (858) 966-5819

Interoperability endpoints

  • Direct secure messaging: mnespeca11759@radychildrens.direct-ci.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1942371703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FILE 57326",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900747326",
            "telephone_number": "858-249-6748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000",
            "telephone_number": "800-926-8273",
            "fax_number": "888-539-8781"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3030 Childrens Way",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921234232",
            "country_code": "US",
            "telephone_number": "858-966-5819",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3020 Childrens Way",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921234223",
            "country_code": "US",
            "telephone_number": "800-926-8273",
            "fax_number": "888-539-8781",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NESPECA",
        "first_name": "MARK",
        "middle_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "CA",
            "license": "G65509",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G65509",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G655090",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.