Eleni Pentheroudakis, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

A75191 Issued in CA

Practice address

5555 Grossmont Center Dr
Emergency Department
La Mesa, CA 91942-3019

Phone

(619) 740-4402

NPI assigned

Jun 3, 2006

Last updated

Feb 18, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Emergency Medicine

Education

University of California, Irvine, California College of Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Team Physicians of Northern California Medical Group IncGroup PAC ID 7113215146, 84 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Grossmont Hospital Hospital, La Mesa, CA, CCN 050026

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

98

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Team Physicians of Northern California Medical Group Inc

  • Emergency Medicine Physician
  • Pleasanton, CA
  • NPI 1649692716
  Medicare reassignment Care Compare group NPD
• Skilled Facility Health Care Solutions Inc

  • Surgery Physician
  • Los Angeles, CA
  • NPI 1104018423
  Medicare reassignment NPD
• Skilled Physicians Group

  • General Practice Physician
  • Glendale, CA
  • NPI 1902444623
  Medicare reassignment
• Skilled Facility Health Care Solutions Inc

  • Surgery Physician
  • Los Angeles, CA
  • NPI 1871756403
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Grossmont Hospital Corporation

  dba Sharp Grossmont Hospital

  • General Acute Care Hospital
  • La Mesa, CA
  • NPI 1528041811
  Care Compare affiliation

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392681600000",
    "number": "1952349987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 GROSSMONT CENTER DR",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423019",
            "telephone_number": "619-740-4402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 GROSSMONT CENTER DR",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423019",
            "telephone_number": "619-740-4402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENTHEROUDAKIS",
        "first_name": "ELENI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-03",
        "last_updated": "2014-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A75191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001899576",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A751910",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pablo Rixiery Pelayo-Aguilar, DPT
• Raquel Pena
• Elaine Pendoley, RN
• Mark W Penn, M.D.
• Jeffrey Penta
• Adriana Peraza-Garcia, PPS
• Liana Perera
• Dave Serafico Perey, O.D
• Jaclyn Perez
• Julie Marie Perez, P.T.

• Emergency Medicine Physician in La Mesa, CA
• Providers in La Mesa, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.