NPIMap

Organization Active NPI

California Cancer Associates for Research and Excellence Inc

  • Non-Pharmacy Dispensing Site
  • La Jolla, CA
National Provider Identifier
1942572672
Registry record updated May 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
A69490 Issued in CA
Legal business name
CALIFORNIA CANCER ASSOCIATES FOR RESEARCH AND EXCELLENCE INC
Practice address
9850 Genesee Ave Ste 560
La Jolla, CA 92037
Phone
(858) 552-1410
NPI assigned
Jan 26, 2012
Last updated
May 10, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2022

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

Authorized official

Name
Jedidiah Monson, M.D.NPI 1669455390
Title
Owner
Phone
(615) 252-7212

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X A69490 CA Primary

Addresses

Primary practice location

9850 Genesee Ave Ste 560
La Jolla, CA 92037

Mailing address

104 Woodmont Blvd Ste 500
Nashville, TN 37205-2245
Phone (615) 252-7212

Other identifiers 1

IdentifierTypeStateIssuer
5642839OtherCANCPDP NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120523000114 CA DME Supplier - Physician - Hematology/Oncology 8022918937 Practice locations: La Jolla, CA

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
California Cancer Associates for Research and Excellence Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1327536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652140800000",
    "number": "1942572672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 WOODMONT BLVD STE 500",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372052245",
            "telephone_number": "615-252-7212",
            "fax_number": "559-421-7004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9850 GENESEE AVE STE 560",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "92037",
            "telephone_number": "858-552-1410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA CANCER ASSOCIATES FOR RESEARCH AND EXCELLENCE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-26",
        "last_updated": "2022-05-10",
        "certification_date": "2022-05-10",
        "status": "A",
        "authorized_official_last_name": "MONSON",
        "authorized_official_first_name": "JEDIDIAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "615-252-7212",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "CA",
            "license": "A69490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP NUMBER",
            "identifier": "5642839",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.