Individual provider Active NPI

Jennifer Ahn, M.D.

  • Maternal & Fetal Medicine Physician
  • San Diego, CA
National Provider Identifier
1972673879
Registry record updated Jul 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
License
CA160026 Issued in CA
Practice address
12264 El Camino Real Ste 204
San Diego, CA 92130-3061
Phone
(858) 794-7700
NPI assigned
Nov 8, 2006
Last updated
Jul 11, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine Physician 207VM0101X 35.123146 OH
Maternal & Fetal Medicine Physician 207VM0101X CA160026 CA Primary

Addresses

Primary practice location

12264 El Camino Real Ste 204
San Diego, CA 92130-3061

Mailing address

1 Perkins SQ
Akron, OH 44308-1063
Phone (330) 543-4500

Other practice location 1

1 Perkins Sq
Akron, OH 44308-1063
Phone (330) 543-4500

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@specialtyobstetrics.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140611000483 OH Practitioner - Obstetrics/Gynecology 5092714030 Reassigns benefits to 1 organization
I20191106003535 CA Practitioner - Obstetrics/Gynecology 5092714030 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Northeastern Ohio University College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Specialty Obstetrics of San DiegoGroup PAC ID 6608911482, 4 clinicians

Practice addresses (Care Compare)

1 Perkins SQ
Akron, OH 44308-1063
Phone (330) 543-1000

1027 S Trimble Rd
Mansfield, OH 44906-3427
Phone (419) 774-6400

1029 S Trimble Rd
Mansfield, OH 44906-3427
Phone (419) 521-2900

12264 El Camino Real
Suite 204
San Diego, CA 92130-3061
Phone (858) 794-7700

One Perkins Square
Akron, OH 44308-1063
Phone (330) 543-1000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CA160026CAMDMaternal & Fetal Medicine Physician
35.123146OHMDMaternal & Fetal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital Medical Center of Akron Current Accepting new patients
Emergency and Acute Care Medical Corporation CurrentSince Jul 29, 2019 Accepting new patients
Specialty Obstetrics of San Diego Maternal & Fetal Medicine CurrentSince Jun 30, 2020 Accepting new patients
Children's Hospital Medical Center of Akron CurrentSince Apr 19, 2014 Accepting new patients
Children's Hospital Medical Center of Akron CurrentSince Apr 19, 2014 Accepting new patients

Locations

12264 El Camino Real
Ste 204
San Diego, CA 92130
Phone (858) 791-7700

3003 Health Center Dr
San Diego, CA 92123
Phone (858) 939-4185

3750 Convoy St
Ste 200
San Diego, CA 92111
Phone (858) 565-1005

7901 Frost St
San Diego, CA 92123
Phone (619) 541-3400

1 Perkins Sq
Akron, OH 44308
Phone (330) 543-8050

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562803200000",
    "number": "1972673879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PERKINS SQ",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443081063",
            "telephone_number": "330-543-4500",
            "fax_number": "330-543-4508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12264 EL CAMINO REAL STE 204",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921303061",
            "telephone_number": "858-794-7700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Perkins Sq",
            "address_purpose": "LOCATION",
            "city": "Akron",
            "state": "OH",
            "postal_code": "443081063",
            "country_code": "US",
            "telephone_number": "330-543-4500",
            "fax_number": "330-543-4508",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AHN",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2019-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "OH",
            "license": "35.123146",
            "primary": false
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "CA",
            "license": "CA160026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@specialtyobstetrics.com",
            "affiliation": "N",
            "endpointDescription": "work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "12264 El Camino Real Ste 204",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921303061",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.