Individual provider Active NPI

Jeffrey Ross Belanoff, MD

  • Internal Medicine Physician
  • Oceanside, CA
National Provider Identifier
1962426510
Registry record updated Dec 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G69781 Issued in CA
Practice address
2205 Vista Way
Oceanside, CA 92054-5661
Phone
(760) 704-5630
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G69781 CA Primary

Addresses

Primary practice location

2205 Vista Way
Oceanside, CA 92054-5661

Mailing address

10790 Rancho Bernardo Rd
San Diego, CA 92127-5705
Phone (760) 806-5400

Other identifiers 1

IdentifierTypeStateIssuer
00G697810MedicaidCA

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
I20090515000449 CA Practitioner - Emergency MedicinePractitioner - Internal Medicine 9032268354 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scripps HealthGroup PAC ID 9234033853, 1,450 clinicians

Practice addresses (Care Compare)

130 Cedar Rd
Vista, CA 92083-5102
Phone (760) 806-5400

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G69781CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Current Accepting new patients
Scripps Health Emergency Medicine Current Accepting new patients
Scripps Health CurrentSince Mar 16, 2009 Accepting new patients
Scripps Health Emergency Medicine CurrentSince Mar 16, 2009 Accepting new patients
Scripps Health Emergency Medicine Past Accepting new patients
Scripps Health Past Accepting new patients

Locations

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

File 54433
Los Angeles, CA 90074
Phone (858) 784-5645

2205 Vista Way
Oceanside, CA 92054
Phone (760) 704-5400

10790 Rancho Bernardo Rd
San Diego, CA 92127
Phone (858) 554-2626

10170 Sorrento Valley Rd
San Diego, CA 92121
Phone (858) 784-5888

130 Cedar Rd
#100
Vista, CA 92083
Phone (760) 806-5400

130 Cedar Rd
Vista, CA 92083
Phone (760) 806-5400

Interoperability endpoints

  • Direct secure messaging: jbelanoff19642@scrippshlth.medalliesdirect.net

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607212800000",
    "number": "1962426510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10790 RANCHO BERNARDO RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275705",
            "telephone_number": "760-806-5400",
            "fax_number": "760-631-3274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 VISTA WAY",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920545661",
            "telephone_number": "760-704-5630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELANOFF",
        "first_name": "JEFFREY",
        "middle_name": "ROSS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2020-12-06",
        "certification_date": "2020-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G69781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G697810",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, CA

Sources for this page

Verify at the official NPI Registry.