Individual provider Active NPI

Patricia N. Speelman, MD

  • Dermatology Physician
  • Oceanside, CA
National Provider Identifier
1982641726
Registry record updated Apr 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
A39411 Issued in CA
Practice address
3629 Vista Way
Oceanside, CA 92056-4522
Phone
(760) 828-9200
Fax
(760) 828-9141
NPI assigned
Jun 1, 2006
Last updated
Apr 12, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X A39411 CA Primary
Dermatopathology Physician 207ND0900X A39411 CA

Addresses

Primary practice location

3629 Vista Way
Oceanside, CA 92056-4522

Mailing address

3629 Vista Way
Oceanside, CA 92056-4522
Phone (760) 828-9200

Other identifiers 1

IdentifierTypeStateIssuer
070003598OtherCARAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1234CAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Specialists, Inc PastSince Oct 1, 1991 Accepting new patients
Dermatology Specialists, Inc Dermatology PastSince Aug 1, 1990 Accepting new patients
Dermatology Specialists Ins Dermatology PastSince Aug 1, 1990 Accepting new patients
Dermatology Specialists Inc Dermatology PastSince Oct 1, 1991 Accepting new patients
Dermatology Specialists Inc Dermatology PastSince Oct 1, 1991 Accepting new patients
Dermatology Specialists Inc. Dermatology PastSince Oct 1, 1991 Accepting new patients
Dermatology Specialists, Inc Dermatology PastSince Oct 1, 1991 Accepting new patients

Organizations & group practices 7

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": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365724800000",
    "number": "1982641726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3629 VISTA WAY",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920564522",
            "telephone_number": "760-828-9200",
            "fax_number": "760-828-9141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3629 VISTA WAY",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920564522",
            "telephone_number": "760-828-9200",
            "fax_number": "760-828-9141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPEELMAN",
        "first_name": "PATRICIA",
        "middle_name": "N.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-01",
        "last_updated": "2013-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A39411",
            "primary": true
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "CA",
            "license": "A39411",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "070003598",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.