Elaheh Etedali, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A6701 Issued in CA

Practice address

2801 Jefferson St
Carlsbad, CA 92008-1720

Phone

(760) 729-4952

Fax

(760) 729-2738

NPI assigned

Jul 6, 2006

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

Family Practice

Education

Midwestern University, Chicago College of Osteopathic Med, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Carlsbad Village Family Practice Medical Associates IncGroup PAC ID 4981695772, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tri-City Medical Center Hospital, Oceanside, CA, CCN 050128

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Carlsbad Village Family Practice Medical Associates Inc

  • Family Medicine Physician
  • Carlsbad, CA
  • NPI 1972547644
  Medicare reassignment Care Compare group NPD

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

• Tri-City Hospital

  • General Acute Care Hospital
  • Oceanside, CA
  • NPI 1801861190
  Care Compare affiliation

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384300800000",
    "number": "1972535581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 JEFFERSON ST",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920081720",
            "telephone_number": "760-729-4952",
            "fax_number": "760-729-2738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 JEFFERSON ST",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920081720",
            "telephone_number": "760-729-4952",
            "fax_number": "760-729-2738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETEDALI",
        "first_name": "ELAHEH",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2013-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A6701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "020A67010",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX67010",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cheryl C Estoesta, PHYSICAL THERAPY
• Amanda Estrada
• Douglas Estrada, ND
• Karla Rosalba Estrada
• Rodrigo Estrella, MA, BCBA
• Naveed Etemadipour
• Leighla Etters, AMFT159183
• Evan K Winograd, M.D., Professional Corporation
• Carol S Evans, O.D.
• Evelyn Louise Evans, PA-C, MS

• Family Medicine Physician in Carlsbad, CA
• Providers in Carlsbad, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2013; 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.