Individual provider Active NPI

Ann Margrette Timog, NP

  • Family Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1962256453
Registry record updated Apr 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95029191 Issued in CA
Practice address
2810 Camino del Rio S Ste 102
San Diego, CA 92108-3819
Phone
(619) 501-6278
NPI assigned
Apr 12, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95029191 CA Primary

Addresses

Primary practice location

2810 Camino del Rio S Ste 102
San Diego, CA 92108-3819

Mailing address

2810 Camino del Rio S Ste 102
San Diego, CA 92108-3819
Phone (619) 501-6278

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240511000380 CA Practitioner - Nurse Practitioner 8527409275 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Senior Medical Associates IncGroup PAC ID 0446339469, 13 clinicians
Del Sur HealthcareGroup PAC ID 1850827395, 61 clinicians

Practice addresses (Care Compare)

2810 Camino del Rio S
Suite 102
San Diego, CA 92108-3819
Phone (619) 299-1419

436 S Magnolia Ave
Suite 101
El Cajon, CA 92020-5219
Phone (760) 978-8596

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95029191CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Senior Medical Associates, Inc. CurrentSince Apr 10, 2024 Accepting new patients
Del Sur Healthcare CurrentSince Feb 21, 2025 Accepting new patients

Locations

436 S Magnolia Ave
Ste 101
El Cajon, CA 92020
Phone (760) 978-8596

2810 Camino del Rio S
Ste 102
San Diego, CA 92108
Phone (619) 299-1419

Organizations & group practices 2

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": "1712880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712880000000",
    "number": "1962256453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2810 CAMINO DEL RIO S STE 102",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083819",
            "telephone_number": "619-501-6278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 CAMINO DEL RIO S STE 102",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083819",
            "telephone_number": "619-501-6278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIMOG",
        "first_name": "ANN MARGRETTE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-12",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95029191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.